Ivan Jambor1,2,3, Anna Kuisma4, Esa Kähkönen5, Jukka Kemppainen6,7, Harri Merisaari8,6,9, Olli Eskola6, Jarmo Teuho6, Ileana Montoya Perez8,9,10, Marko Pesola8, Hannu J Aronen8,10, Peter J Boström5, Pekka Taimen11, Heikki Minn6,4. 1. Department of Diagnostic Radiology, University of Turku, Kiinamyllynkatu 4-8, P.O. Box 52, FI-20521, Turku, Finland. ivan.jambor@utu.fi. 2. Department of Radiology, University of Massachusetts Medical School - Baystate, Springfield, MA, USA. ivan.jambor@utu.fi. 3. Turku PET Centre, Turku, Finland. ivan.jambor@utu.fi. 4. Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland. 5. Department of Urology, Turku University Hospital, Turku, Finland. 6. Turku PET Centre, Turku, Finland. 7. Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland. 8. Department of Diagnostic Radiology, University of Turku, Kiinamyllynkatu 4-8, P.O. Box 52, FI-20521, Turku, Finland. 9. Department of Information Technology, University of Turku, Turku, Finland. 10. Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland. 11. Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland.
Abstract
PURPOSE: The purpose of this study was to evaluate 18F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa). METHODS: Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq 18F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUVmax) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (VT). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455. RESULTS: In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p < 0.01) outperformed that of PET/CT while no differences were detected between PET/MRI and mpMRI. SUVmax and VT of Gleason score (GS) >3 + 4 tumors were significantly (p < 0.05) higher than those for GS 3 + 3 and benign hyperplasia. A total of 442 lymph nodes were evaluable for staging, and PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes. CONCLUSIONS: Quantitative 18F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. 18F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI.
PURPOSE: The purpose of this study was to evaluate 18F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa). METHODS: Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq 18F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUVmax) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (VT). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455. RESULTS: In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p < 0.01) outperformed that of PET/CT while no differences were detected between PET/MRI and mpMRI. SUVmax and VT of Gleason score (GS) >3 + 4 tumors were significantly (p < 0.05) higher than those for GS 3 + 3 and benign hyperplasia. A total of 442 lymph nodes were evaluable for staging, and PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes. CONCLUSIONS: Quantitative 18F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. 18F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI.
Entities:
Keywords:
18F-FACBC; Diffusion-weighted imaging; PET/CT; PET/MRI; Prostate cancer
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