Feasibility and Initial Results: Fluciclovine Positron Emission Tomography/Ultrasound Fusion Targeted Biopsy of Recurrent Prostate Cancer
| Autor: | David M. Schuster, Akinyemi A. Akintayo, Mark M. Goodman, Baowei Fei, Adeboye O. Osunkoya, Olayinka A. Abiodun-Ojo, Mehrdad Alemozaffar, Peter T. Nieh, Viraj A. Master, Funmilayo Tade, Oladunni Akin-Akintayo |
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| Rok vydání: | 2019 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Biopsy Urology Carboxylic Acids 030232 urology & nephrology Targeted biopsy Article 03 medical and health sciences 0302 clinical medicine medicine Medical imaging Humans Prospective Studies Positron emission Aged Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Ultrasound Prostatic Neoplasms Middle Aged Treatment Outcome Positron emission tomography Positron-Emission Tomography Feasibility Studies Recurrent prostate cancer Radiology Neoplasm Recurrence Local business Cyclobutanes |
| Zdroj: | Journal of Urology. 202:413-421 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1097/ju.0000000000000200 |
| Popis: | PURPOSE: We assessed the feasibility and cancer detection rate of fluciclovine ((18)F) positron emission tomography-ultrasound fusion targeted biopsy vs standard template biopsy in the same patient with biochemical failure after nonsurgical therapy for prostate cancer. MATERIALS AND METHODS: A total of 21 patients with a mean ± SD prostate specific antigen of 7.4 ± 6.8 ng/ml and biochemical failure after nonoperative prostate cancer treatment underwent fluciclovine ((18)F) positron emission tomography- computerized tomography (mean 364.1 ± 37.7 MBq) and planning transrectal prostate ultrasound with 3-dimensional image reconstruction. Focal prostatic activity on positron emission tomography was delineated and co-registered with planning ultrasound. During the subsequent biopsy session computer generated 12-core template biopsies were performed and then fluciclovine defined targets were revealed and biopsied. Histological analysis of template and targeted cores were completed. RESULTS: Template biopsy was positive for malignancy in 6 of 21 patients (28.6%), including 10 of 124 regions and 11 of 246 cores, vs targeted biopsy in 10 of 21 (47.6%), including 17 of 50 regions and 40 of 125 cores. Five of 21 patients had positive findings on targeted biopsy only and 1 of 21 had positive findings on template biopsy only. An additional case was upgraded from Grade Group 2 to 3 on targeted biopsy. Extraprostatic disease was detected in 8 of 21 men (38.1%) with histological confirmation in all 3 who underwent lesion biopsy. CONCLUSIONS: Fluciclovine positron emission tomography real-time ultrasound fusion guidance for biopsy is feasible in patients with biochemical failure after nonsurgical therapy for prostate cancer. It identifies more recurrent prostate cancer using fewer cores compared with template biopsy in the same patient. Further study is required to determine in what manner targeted biopsy may augment template biopsy of recurrent prostate cancer. |
| Databáze: | OpenAIRE |
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