Laura Van den Bergh1, Evelyne Lerut2, Karin Haustermans3, Christophe M Deroose4, Raymond Oyen5, Sofie Isebaert3, Tom Budiharto6, Filip Ameye7, Felix M Mottaghy8, Kris Bogaerts9, Hendrik Van Poppel7, Steven Joniau7. 1. Radiation Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium. Electronic address: laura.vandenbergh@uzleuven.be. 2. Pathology, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. 3. Radiation Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium. 4. Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium. 5. Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; Radiology, University Hospitals Leuven, Belgium. 6. Radiation Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium; Department of Radiotherapy, Catharinaziekenhuis Eindhoven, Eindhoven, the Netherlands. 7. Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium. 8. Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany. 9. l-Biostat, KU Leuven, Leuven, Belgium.
Abstract
PURPOSE: Accurate staging modalities to diagnose lymph node involvement in patients with prostate cancer (PCa) are lacking. We wanted to prospectively assess sensitivity, specificity, and positive predictive value (PPV) and negative predictive value of (11)C-choline positron emission tomography (PET)-computed tomography (CT) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for nodal staging in patients with PCa at high risk for lymph node involvement. MATERIAL AND METHODS: In total, 75 patients with a risk≥10% but<35% for lymph node (LN) metastases (Partin tables) who had N0 lesions based on the findings of contrast-enhanced CT scans were included. Patients underwent (11)C-choline PET-CT and DW MRI before surgery, which consisted of a superextended lymph node dissection followed by radical prostatectomy. LNs were serially sectioned and histopathologically examined after pankeratin staining. These results were used as the gold standard to compare with the imaging results. RESULTS: Of 1,665 resected LNs (median = 21, range: 7-49), 106 affected LNs (median = 2, range: 1-10) were found in 37 of 75 patients (49%). On a region-based analysis, we found a low sensitivity of 8.2% and 9.5% and a PPV of 50.0% and 40.0% for (11)C-choline PET-CT and DW MRI, respectively. The patient-based analysis showed a sensitivity of 18.9% and 36.1% for and a PPV of 63.6% and 86.7% (11)C-choline PET-CT and DW MRI, respectively. Even when both imaging modalities were combined, sensitivity values remained too low to be clinically useful. CONCLUSIONS: Because of the low sensitivity, there is no indication for routine clinical use of either (11)C-choline PET-CT or DW MRI for LN staging in patients with PCa, in whom CT scan findings were normal.
PURPOSE: Accurate staging modalities to diagnose lymph node involvement in patients with prostate cancer (PCa) are lacking. We wanted to prospectively assess sensitivity, specificity, and positive predictive value (PPV) and negative predictive value of (11)C-choline positron emission tomography (PET)-computed tomography (CT) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for nodal staging in patients with PCa at high risk for lymph node involvement. MATERIAL AND METHODS: In total, 75 patients with a risk≥10% but<35% for lymph node (LN) metastases (Partin tables) who had N0 lesions based on the findings of contrast-enhanced CT scans were included. Patients underwent (11)C-choline PET-CT and DW MRI before surgery, which consisted of a superextended lymph node dissection followed by radical prostatectomy. LNs were serially sectioned and histopathologically examined after pankeratin staining. These results were used as the gold standard to compare with the imaging results. RESULTS: Of 1,665 resected LNs (median = 21, range: 7-49), 106 affected LNs (median = 2, range: 1-10) were found in 37 of 75 patients (49%). On a region-based analysis, we found a low sensitivity of 8.2% and 9.5% and a PPV of 50.0% and 40.0% for (11)C-choline PET-CT and DW MRI, respectively. The patient-based analysis showed a sensitivity of 18.9% and 36.1% for and a PPV of 63.6% and 86.7% (11)C-choline PET-CT and DW MRI, respectively. Even when both imaging modalities were combined, sensitivity values remained too low to be clinically useful. CONCLUSIONS: Because of the low sensitivity, there is no indication for routine clinical use of either (11)C-choline PET-CT or DW MRI for LN staging in patients with PCa, in whom CT scan findings were normal.
Authors: Giorgio Brembilla; Paolo Dell'Oglio; Armando Stabile; Alessandro Ambrosi; Giulia Cristel; Lisa Brunetti; Anna Damascelli; Massimo Freschi; Antonio Esposito; Alberto Briganti; Francesco Montorsi; Alessandro Del Maschio; Francesco De Cobelli Journal: Eur Radiol Date: 2017-12-21 Impact factor: 5.315
Authors: Lars J Petersen; Julie B Nielsen; Niels C Langkilde; Astrid Petersen; Ali Afshar-Oromieh; Nandita M De Souza; Katja De Paepe; Rune V Fisker; Dennis T Arp; Jesper Carl; Uwe Haberkorn; Helle D Zacho Journal: World J Urol Date: 2019-06-12 Impact factor: 4.226
Authors: Mehrdad Alemozaffar; Akinyemi A Akintayo; Olayinka A Abiodun-Ojo; Dattatraya Patil; Faisal Saeed; Yijian Huang; Adeboye O Osunkoya; Mark M Goodman; Martin Sanda; David M Schuster Journal: J Urol Date: 2020-04-29 Impact factor: 7.450
Authors: Daniela A Ferraro; Helena I Garcia Schüler; Urs J Muehlematter; Daniel Eberli; Julian Müller; Alexander Müller; Roger Gablinger; Helmut Kranzbühler; Aurelius Omlin; Philipp A Kaufmann; Thomas Hermanns; Irene A Burger Journal: Eur J Nucl Med Mol Imaging Date: 2019-12-04 Impact factor: 9.236
Authors: Annelies Gonnissen; Sofie Isebaert; Christiaan Perneel; Chad M McKee; Filip Van Utterbeeck; Evelyne Lerut; Clare Verrill; Richard J Bryant; Steven Joniau; Ruth J Muschel; Karin Haustermans Journal: Am J Pathol Date: 2018-01-12 Impact factor: 4.307