Shay Golan1, Vladimir Sopov, Jack Baniel, David Groshar. 1. Institute of Urology, Department of Nuclear Medicine, Rabin Medical Center, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. shaygo1@yahoo.com
Abstract
PURPOSE: 11C-choline was postulated to provide better diagnostic capabilities than other tracers used in positron emission tomography/computerized tomography for staging urothelial carcinoma. We compared the value of using 11C-choline with the well investigated 18F-FDG tracer in this setting. MATERIALS AND METHODS: The study group included 20 consecutive patients with bladder cancer who underwent evaluation for local and metastatic disease using 11C-choline and 18F-FDG positron emission tomography/computerized tomography. Patients were treated with radical cystectomy with lymph node dissection, radiation therapy or chemotherapy independent of positron emission tomography/computerized tomography results. The histopathological findings (when available), followup positron emission tomography and radiological imaging served as the reference standard. Using the paired t test we compared the maximum standardized uptake and lesion-to-background ratio of the tracers. The positive predictive values were determined. RESULTS: A total of 51 lesions showed abnormal tracer activity. The positive predictive value for all detected lesions was 84.7% for 11C-choline positron emission tomography/computerized tomography and 90.7% for 18F-FDG positron emission tomography/computerized tomography. The corresponding positive predictive values for extravesical lesions were 79.4% and 88.2%, respectively. Discrepant findings between the tracers were noted at 11 sites. 18F-FDG positron emission tomography/computerized tomography correctly identified 4 extravesical metastases missed by choline positron emission tomography/computerized tomography in the absence of a contrary observation. Mean maximum standardized uptake and lesion-to-background ratio at extravesical sites were significantly higher for FDG. CONCLUSIONS: Within the limitations of a relatively small number of patients and partial histopathological analysis, 11C-choline positron emission tomography/computerized tomography appears to have no advantage compared to 18F-FDG positron emission tomography/computerized tomography in the detection of metastatic bladder cancer. 18F-FDG positron emission tomography/computerized tomography has a tendency toward greater accuracy.
PURPOSE:11C-choline was postulated to provide better diagnostic capabilities than other tracers used in positron emission tomography/computerized tomography for staging urothelial carcinoma. We compared the value of using 11C-choline with the well investigated 18F-FDG tracer in this setting. MATERIALS AND METHODS: The study group included 20 consecutive patients with bladder cancer who underwent evaluation for local and metastatic disease using 11C-choline and 18F-FDG positron emission tomography/computerized tomography. Patients were treated with radical cystectomy with lymph node dissection, radiation therapy or chemotherapy independent of positron emission tomography/computerized tomography results. The histopathological findings (when available), followup positron emission tomography and radiological imaging served as the reference standard. Using the paired t test we compared the maximum standardized uptake and lesion-to-background ratio of the tracers. The positive predictive values were determined. RESULTS: A total of 51 lesions showed abnormal tracer activity. The positive predictive value for all detected lesions was 84.7% for 11C-choline positron emission tomography/computerized tomography and 90.7% for 18F-FDG positron emission tomography/computerized tomography. The corresponding positive predictive values for extravesical lesions were 79.4% and 88.2%, respectively. Discrepant findings between the tracers were noted at 11 sites. 18F-FDG positron emission tomography/computerized tomography correctly identified 4 extravesical metastases missed by choline positron emission tomography/computerized tomography in the absence of a contrary observation. Mean maximum standardized uptake and lesion-to-background ratio at extravesical sites were significantly higher for FDG. CONCLUSIONS: Within the limitations of a relatively small number of patients and partial histopathological analysis, 11C-choline positron emission tomography/computerized tomography appears to have no advantage compared to 18F-FDG positron emission tomography/computerized tomography in the detection of metastatic bladder cancer. 18F-FDG positron emission tomography/computerized tomography has a tendency toward greater accuracy.
Authors: Vincenzo Cuccurullo; Giuseppe Danilo Di Stasio; Francesco Manti; Pierpaolo Arcuri; Rocco Damiano; Giuseppe Lucio Cascini Journal: Diagnostics (Basel) Date: 2021-05-11