The value of 18F-choline PET/CT in patients with elevated PSA-level and negative prostate needle biopsy for localisation of prostate cancer
| Autor: | Ewald Kresnik, H.J. Gallowitsch, Peter Lind, I. Gomez-Segovia, S. Matschnig, S. Kohlfürst, I. Igerc |
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| Rok vydání: | 2007 |
| Předmět: |
PCA3
Male medicine.medical_specialty Prostate biopsy 18F-choline Sensitivity and Specificity Choline Prostate cancer Prostate Biopsy medicine Humans Radiology Nuclear Medicine and imaging False Negative Reactions Aged PET-CT medicine.diagnostic_test business.industry Biopsy Needle Prostatic Neoplasms Reproducibility of Results General Medicine Middle Aged Prostate-Specific Antigen medicine.disease Elevated PSA medicine.anatomical_structure Positron-Emission Tomography Radiology Radiopharmaceuticals business Tomography X-Ray Computed |
| Zdroj: | European journal of nuclear medicine and molecular imaging. 35(5) |
| ISSN: | 1619-7070 |
| Popis: | Patients with persistent elevated PSA and repeated negative prostate biopsy, that means having the prostate biopsied at multiple times, were investigated with 18F-choline PET/CT to delineate prostate cancer and guide renewed prostate biopsy.Twenty patients with elevated PSA and negative prostate biopsies underwent 18F-choline PET/CT. We performed an early examination of the pelvic region 3-5 min after application. After 30 minutes a whole body PET/CT examination was performed. Image analysis was performed visually and by semi-quantitative analysis calculating the maximum standardised uptake value (SUVmax). 18F-choline uptake was defined as focal, multifocal or inhomogeneous. After the 18F-choline PET/CT, all patients underwent a repeated prostate biopsy, and in the cases where a focal or multifocal uptake was found, the biopsy was guided by the result of the examination.Qualitative image analysis revealed focal 18F-choline uptake in 13 out of 20 patients. In five patients, prostate cancer was revealed by repeated aspiration biopsy. None of the patients with a multifocal or inhomogeneous 18F-choline uptake had a malignant neoplasm in the prostate. Semiquantitative analysis performed with SUVmax was not helpful in the discrimination of malignancy but showed high values also in benign prostate diseases, as well as in normal prostate tissue. The dual-phase protocol delivered no clear benefit in discriminating malignancy from benign alterations.The use of 18F-choline cannot be generally recommended for localising prostate cancer; however, in highly selected patients, we found useful additional information. In 25% of patients, 18F-choline PET/CT allowed the identification of neoplastic prostatic zones. |
| Databáze: | OpenAIRE |
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