BACKGROUND: The detection of lymph node metastases (LNMs) is one of the biggest challenges in imaging in urology. OBJECTIVE: To evaluate the accuracy of combined 18F-fluoroethylcholine (FEC) positron emission tomography (PET)/computed tomography (CT) in the detection of LNMs in prostate cancer (PCa) patients with rising prostate-specific antigen (PSA) level after radical prostatectomy. DESIGN, SETTINGS, AND PARTICIPANTS: From June 2005 until November 2011, 56 PCa patients with biochemical recurrence after radical prostatectomy underwent bilateral pelvic and/or retroperitoneal lymphadenectomy based on a positive 18F-FEC PET/CT scan. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The findings of PET/CT were compared with the histologic results. RESULTS AND LIMITATIONS: Median PSA value at the time of 18F-FEC PET/CT analysis was 6.0 ng/ml (interquartile range: 1.7-9.4 ng/ml). In 48 of 56 (85.7%) patients with positive 18F-FEC PET/CT findings, histologic examination confirmed the presence of PCa LNMs. Of 1149 lymph nodes that were removed and histologically evaluated, 282 (24.5%) harbored metastasis. The mean number of lymph nodes removed per surgical procedure was 21 (standard deviation: ± 18.3). A lesion-based analysis yielded 18F-FEC PET/CT sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 39.7%, 95.8%, 75.7%, and 83.0%, respectively. A site-based analysis yielded sensitivity, specificity, PPV, and NPV of 68.4%, 73.3%, 81.3%, and 57.9%, respectively. Patients with negative PET/CT did not undergo surgery, thus sensitivity, specificity, and negative predictive value on a patient basis could not be calculated. CONCLUSIONS: A positive 18F-FEC PET/CT result correctly predicted the presence of LNM in the majority of PCa patients with biochemical failure after radical prostatectomy but did not allow for localization of all metastatic lymph nodes and therefore was not adequately accurate for the precise estimation of extent of nodal recurrence in these patients.
BACKGROUND: The detection of lymph node metastases (LNMs) is one of the biggest challenges in imaging in urology. OBJECTIVE: To evaluate the accuracy of combined 18F-fluoroethylcholine (FEC) positron emission tomography (PET)/computed tomography (CT) in the detection of LNMs in prostate cancer (PCa) patients with rising prostate-specific antigen (PSA) level after radical prostatectomy. DESIGN, SETTINGS, AND PARTICIPANTS: From June 2005 until November 2011, 56 PCa patients with biochemical recurrence after radical prostatectomy underwent bilateral pelvic and/or retroperitoneal lymphadenectomy based on a positive 18F-FEC PET/CT scan. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The findings of PET/CT were compared with the histologic results. RESULTS AND LIMITATIONS: Median PSA value at the time of 18F-FEC PET/CT analysis was 6.0 ng/ml (interquartile range: 1.7-9.4 ng/ml). In 48 of 56 (85.7%) patients with positive 18F-FEC PET/CT findings, histologic examination confirmed the presence of PCa LNMs. Of 1149 lymph nodes that were removed and histologically evaluated, 282 (24.5%) harbored metastasis. The mean number of lymph nodes removed per surgical procedure was 21 (standard deviation: ± 18.3). A lesion-based analysis yielded 18F-FEC PET/CT sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 39.7%, 95.8%, 75.7%, and 83.0%, respectively. A site-based analysis yielded sensitivity, specificity, PPV, and NPV of 68.4%, 73.3%, 81.3%, and 57.9%, respectively. Patients with negative PET/CT did not undergo surgery, thus sensitivity, specificity, and negative predictive value on a patient basis could not be calculated. CONCLUSIONS: A positive 18F-FEC PET/CT result correctly predicted the presence of LNM in the majority of PCa patients with biochemical failure after radical prostatectomy but did not allow for localization of all metastatic lymph nodes and therefore was not adequately accurate for the precise estimation of extent of nodal recurrence in these patients.
Authors: Simona Malaspina; Ugo De Giorgi; Jukka Kemppainen; Angelo Del Sole; Giovanni Paganelli Journal: Radiol Med Date: 2018-08-16 Impact factor: 3.469
Authors: Henrik Kjölhede; Göran Ahlgren; Helen Almquist; Fredrik Liedberg; Kerstin Lyttkens; Thomas Ohlsson; Ola Bratt Journal: World J Urol Date: 2015-04-01 Impact factor: 4.226
Authors: Francesco Ceci; Ken Herrmann; Paolo Castellucci; Tiziano Graziani; Christina Bluemel; Riccardo Schiavina; Christian Vollmer; Sabine Droll; Eugenio Brunocilla; Renzo Mazzarotto; Andreas K Buck; Stefano Fanti Journal: Eur J Nucl Med Mol Imaging Date: 2014-08-15 Impact factor: 9.236
Authors: Giampiero Giovacchini; Elena Incerti; Paola Mapelli; Margarita Kirienko; Alberto Briganti; Giorgio Gandaglia; Francesco Montorsi; Luigi Gianolli; Maria Picchio Journal: Eur J Nucl Med Mol Imaging Date: 2015-02-20 Impact factor: 9.236
Authors: David Pfister; Daniel Porres; Axel Heidenreich; Isabel Heidegger; Ruth Knuechel; Florian Steib; Florian F Behrendt; Frederik A Verburg Journal: Eur J Nucl Med Mol Imaging Date: 2016-03-19 Impact factor: 9.236
Authors: M Picchio; G Berardi; A Fodor; E Busnardo; C Crivellaro; G Giovacchini; C Fiorino; M Kirienko; E Incerti; C Messa; L Gianolli; N Di Muzio Journal: Eur J Nucl Med Mol Imaging Date: 2014-03-06 Impact factor: 9.236
Authors: D K Osmonov; A V Aksenov; C A Jilg; W Schultze-Seeman; C M Naumann; M F Hamann; K Bothe; K-P Jünemann Journal: Urologe A Date: 2016-02 Impact factor: 0.639