Diagnostic accuracy of 18F-fluciclovine PET/CT in primary lymph node staging of prostate cancer
| Autor: | Jean-Paul A. van Basten, A.J.W. Beulens, Mark J. Roef, R.J. Hoekstra, Dirk Wyndaele, Diederik M. Somford, Lenneke J M Brouwer, Eric Vrijhof, Michiel Sedelaar |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Carboxylic Acids Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Positron Emission Tomography Computed Tomography Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] Humans Medicine Radiology Nuclear Medicine and imaging Lymph node Aged Neoplasm Staging PET-CT business.industry Incidence (epidemiology) Prostatic Neoplasms General Medicine Middle Aged medicine.disease Dissection medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Histopathology Radiology Lymph business Cyclobutanes Cohort study |
| Zdroj: | Nuclear Medicine Communications, 42, 5, pp. 476-481 Nuclear Medicine Communications, 42, 476-481 |
| ISSN: | 0143-3636 |
| Popis: | Item does not contain fulltext INTRODUCTION: To determine preoperative diagnostic accuracy of 18F-fluciclovine PET/CT-scan in detection (or exclusion) of lymph node metastases (LNM) in men with prostate cancer (PCa) in comparison to the histopathological results of the extended pelvic lymph node dissection (e-PLND). METHODS: A retrospective medical records-based cohort study, including 47 men with primary PCa who received 18F-fluciclovine PET/CT and subsequent e-PLND for lymph node staging. Incidence and number of visualized LNM, their locations and diameters on 18F-fluciclovine PET/CT were recorded in comparison to the histopathological results of the e-PLND as reference. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and diagnostic accuracy of 18F-fluciclovine PET/CT were calculated on the basis of histopathology results after e-PLND. RESULTS: Forty-seven men were eligible for analysis. Median lymph node yield was 19 (range 10-70). A total of 996 lymph nodes were removed, and 59 metastases were found in 21 cases (45%). Preoperative PET was issued 'positive' in 11 men and in 9 of them (82%) this was histopathologically confirmed resulting in a PPV of 82% (95% CI, 51-96). On the contrary, PET was issued 'negative' in 36 cases, but in 12 of them (33%) metastases were detected in the e-PLND specimen, resulting in an NPV of 67% (95% CI, 50-80). The patient-based sensitivity was 43% (95% CI, 24-64) and the patient-based specificity rate was 92% (95% CI, 75-99), whereas overall diagnostic accuracy was established to be 70% in the present cohort. CONCLUSION: 18F-Fluciclovine PET/CT has a high specificity and positive predicted value for the presence of LNM in men with prostate cancer. However, the sensitivity and NPV seem to be limited to exclude the absence of LNM at a clinically acceptable level. Prospective evaluation is necessary to define patients who may benefit from 18F-fluciclovine PET/CT as a triage test for the indication for e-PLND. |
| Databáze: | OpenAIRE |
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