Histological Validation of 11 Carbon-Acetate Positron Emission Tomography/Computerized Tomography in Detecting Lymph Node Metastases in Prostate Cancer
| Autor: | John D. Carpten, Michael Qiu, Chisato Ohe, Fabio Almeida, Andre Luis de Castro Abreu, Parkash S. Gill, Nariman Ahmadi, Mahul B. Amin, Inderbir S. Gill, Jie Cai, Manju Aron, Mariana C. Stern, Peter Kuhn, Giovanni Cacciamani, Gus Miranda, Zarko Manojlovic, Nieroshan Rajarubendra |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.diagnostic_test
business.industry Urology medicine.medical_treatment 030232 urology & nephrology Standardized uptake value medicine.disease Article 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine.anatomical_structure Positron emission tomography 030220 oncology & carcinogenesis medicine Medical imaging Lymphadenectomy Tomography Lymph business Nuclear medicine Lymph node |
| Zdroj: | J Urol |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | PURPOSE: Conventional imaging cannot definitively detect nodal metastases of prostate cancer. We histologically validated (11)C-acetate positron emission tomography/computerized tomography to identify nodal metastases, examining prostate cancer factors that influence detection rates. MATERIALS AND METHODS: Patients with (11)C-acetate avid positron emission tomography/computerized tomography imaged pelvic/retroperitoneal lymph nodes underwent high extended robotic lymphadenectomy. A standardized mapping template comprising 8 predetermined anatomical regions was dissected during lymphadenectomy, allowing for matched, region based analysis and comparison of imaging and histological data. RESULTS: In 25 patients a total of 2,149 lymph nodes were excised (mean 86 per patient, range 27 to 136) and 528 (22%) harbored metastases (mean 21 positive nodes per patient, range 0 to 109). A total of 174 anatomical regions had matching imaging histological data. (11)C-acetate positron emission tomography/computerized tomography accurately identified 48 node-positive regions and accurately ruled out 88 regions as metastasis-free. (11)C-acetate sensitivity, specificity, and positive and negative predictive values were 67%, 84%, 74% and 79%, respectively. An increasing, histologically measured metastatic lesion size in long axis diameter of 5 or less, 6 to 10, 11 to 15, 16 to 20 and 21 mm or greater correlated with improved (11)C-acetate detection rates of 45%, 62%, 81%, 89% and 100%, respectively. Each standard uptake value unit increase correlated with a 1.9 mm increase in nodal long axis diameter (p |
| Databáze: | OpenAIRE |
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