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Detection of lymph node metastases in patients with prostate cancer : Comparing conventional and digital [18F]-fluorocholine PET-CT using histopathology as a reference

Bjöersdorff, Mimmi LU orcid ; Puterman, Christopher ; Oddstig, Jenny LU ; Amidi, Jennifer ; Zackrisson, Sophia LU ; Kjölhede, Henrik ; Bjartell, Anders LU ; Wollmer, Per LU and Trägårdh, Elin LU (2022) In Clinical Physiology and Functional Imaging 42(6). p.381-388
Abstract

Background: Positron emission tomography-computed tomography (PET-CT) with [18F]-fluorocholine (FCH) is used to detect and stage metastatic lymph nodes in patients with prostate cancer. Improvements to hardware and software have recently been made. We compared the capability of detecting regional lymph node metastases using conventional and digital silicon photomultiplier (SiPM)-based PET-CT technology for FCH. Extended pelvic lymph node dissection (ePLND) histopathology was used as a reference method. Methods: The study retrospectively examined 177 patients with intermediate or high-risk prostate cancer who had undergone staging with FCH PET-CT before ePLND. Images were obtained with either the conventional Philips Gemini... (More)

Background: Positron emission tomography-computed tomography (PET-CT) with [18F]-fluorocholine (FCH) is used to detect and stage metastatic lymph nodes in patients with prostate cancer. Improvements to hardware and software have recently been made. We compared the capability of detecting regional lymph node metastases using conventional and digital silicon photomultiplier (SiPM)-based PET-CT technology for FCH. Extended pelvic lymph node dissection (ePLND) histopathology was used as a reference method. Methods: The study retrospectively examined 177 patients with intermediate or high-risk prostate cancer who had undergone staging with FCH PET-CT before ePLND. Images were obtained with either the conventional Philips Gemini PET-CT (n = 93) or the digital SiPM-based GE Discovery MI PET-CT (n = 84) and compared. Results: Images that were obtained using the Philips Gemini PET-CT system showed 19 patients (20%) with suspected lymph node metastases, whereas the GE Discovery MI PET-CT revealed 36 such patients (43%). The sensitivity, specificity, and positive and negative predictive values were 0.3, 0.84, 0.47, and 0.72 for the Philips Gemini, while they were 0.58, 0.62, 0.31, and 0.83 for the GE Discovery MI, respectively. The areas under the curves in a receiver operating characteristic curve analysis were similar between the two PET-CT systems (0.57 for Philips Gemini and 0.58 for GE Discovery MI, p = 0.89). Conclusions: Marked differences in sensitivity and specificity were found for the different PET-CT systems, although the overall diagnostic performance was similar. These differences are probably due to differences in both hardware and software, including reconstruction algorithms, and should be considered when new technology is introduced.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
diagnostic performance, lymph node dissection, positron emission tomography-computed tomography, silicon photomultiplier-based technology
in
Clinical Physiology and Functional Imaging
volume
42
issue
6
pages
8 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:35866190
  • scopus:85136813566
ISSN
1475-0961
DOI
10.1111/cpf.12770
language
English
LU publication?
yes
id
45d30ebc-685e-4691-8035-30aad5bf9e19
date added to LUP
2022-10-26 15:25:57
date last changed
2024-04-18 10:35:00
@article{45d30ebc-685e-4691-8035-30aad5bf9e19,
  abstract     = {{<p>Background: Positron emission tomography-computed tomography (PET-CT) with [<sup>18</sup>F]-fluorocholine (FCH) is used to detect and stage metastatic lymph nodes in patients with prostate cancer. Improvements to hardware and software have recently been made. We compared the capability of detecting regional lymph node metastases using conventional and digital silicon photomultiplier (SiPM)-based PET-CT technology for FCH. Extended pelvic lymph node dissection (ePLND) histopathology was used as a reference method. Methods: The study retrospectively examined 177 patients with intermediate or high-risk prostate cancer who had undergone staging with FCH PET-CT before ePLND. Images were obtained with either the conventional Philips Gemini PET-CT (n = 93) or the digital SiPM-based GE Discovery MI PET-CT (n = 84) and compared. Results: Images that were obtained using the Philips Gemini PET-CT system showed 19 patients (20%) with suspected lymph node metastases, whereas the GE Discovery MI PET-CT revealed 36 such patients (43%). The sensitivity, specificity, and positive and negative predictive values were 0.3, 0.84, 0.47, and 0.72 for the Philips Gemini, while they were 0.58, 0.62, 0.31, and 0.83 for the GE Discovery MI, respectively. The areas under the curves in a receiver operating characteristic curve analysis were similar between the two PET-CT systems (0.57 for Philips Gemini and 0.58 for GE Discovery MI, p = 0.89). Conclusions: Marked differences in sensitivity and specificity were found for the different PET-CT systems, although the overall diagnostic performance was similar. These differences are probably due to differences in both hardware and software, including reconstruction algorithms, and should be considered when new technology is introduced.</p>}},
  author       = {{Bjöersdorff, Mimmi and Puterman, Christopher and Oddstig, Jenny and Amidi, Jennifer and Zackrisson, Sophia and Kjölhede, Henrik and Bjartell, Anders and Wollmer, Per and Trägårdh, Elin}},
  issn         = {{1475-0961}},
  keywords     = {{diagnostic performance; lymph node dissection; positron emission tomography-computed tomography; silicon photomultiplier-based technology}},
  language     = {{eng}},
  month        = {{11}},
  number       = {{6}},
  pages        = {{381--388}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{Detection of lymph node metastases in patients with prostate cancer : Comparing conventional and digital [<sup>18</sup>F]-fluorocholine PET-CT using histopathology as a reference}},
  url          = {{http://dx.doi.org/10.1111/cpf.12770}},
  doi          = {{10.1111/cpf.12770}},
  volume       = {{42}},
  year         = {{2022}},
}