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Combined (18) F-fluorocholine and (18) F-fluoride positron emission tomography/computed tomography imaging for staging of high-risk prostate cancer.

Kjölhede, Henrik; Ahlgren, Göran LU ; Almquist, Helen; Liedberg, Fredrik LU ; Lyttkens, Kerstin LU ; Ohlsson, Tomas G LU and Bratt, Ola LU (2012) In BJU International 110(10). p.1501-1506
Abstract
Study Type - Diagnosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Positron emission tomography/computed tomography (PET/CT) with choline and fluoride for the detection of metastases in patients with prostate cancer have each been evaluated, with mixed results. Choline PET/CT has been evaluated against pelvic lymphadenectomy, generally with a low sensitivity but a high specificity; however, the study populations have been heterogenous. Fluoride PET/CT has been evaluated against other imaging methods, such as bone scan, single photon emission CT and MRI, and has been shown to have high specificity as well as sensitivity for bone metastases, but there are no studies with biopsy verification. This... (More)
Study Type - Diagnosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Positron emission tomography/computed tomography (PET/CT) with choline and fluoride for the detection of metastases in patients with prostate cancer have each been evaluated, with mixed results. Choline PET/CT has been evaluated against pelvic lymphadenectomy, generally with a low sensitivity but a high specificity; however, the study populations have been heterogenous. Fluoride PET/CT has been evaluated against other imaging methods, such as bone scan, single photon emission CT and MRI, and has been shown to have high specificity as well as sensitivity for bone metastases, but there are no studies with biopsy verification. This is the first study that evaluates the clinical use of both choline and fluoride PET/CT on the same patients in a well-defined population of patients with high-risk prostate cancer. OBJECTIVE: • To investigate how often positron emission tomography/computed tomography (PET/CT) scans, with both (18) F-fluorocholine and (18) F-fluoride as markers, add clinically relevant information for patients with prostate cancer who have high-risk tumours and a normal or inconclusive planar bone scan. PATIENTS AND METHODS: • Patients with prostate cancer with prostate specific antigen (PSA) levels between 20 and 99 ng/mL and/or Gleason score 8-10 tumours, planned for treatment with curative intent based on routine staging with a negative or inconclusive bone scan, were further investigated with a (18) F-fluorocholine and a (18) F-fluoride PET/CT. • None of the patients received hormonal therapy before the staging procedures were completed. RESULTS: • For 50 of the 90 included patients (56%) one or both PET/CT scans indicated metastases. • (18) F-fluorocholine PET/CT indicated lymph node metastases and/or bone metastases in 35 patients (39%). • (18) F-fluoride PET/CT was suggestive for bone metastases in 37 patients (41%). • In 18 patients (20%) the PET/CT scans indicated widespread metastases, leading to a change in therapy intent from curative to non-curative. • Of the patients with positive scans, 74% had Gleason score 8-10 tumours. Of the patients with Gleason score 8-10 tumours, 64% had positive scans. CONCLUSIONS: • PET/CT scans with (18) F-fluorocholine and (18) F-fluoride commonly detect metastases in patients with high-risk prostate cancer and a negative or inconclusive bone scan. • For 20% of the patients the results of the PET/CT scans changed the treatment plan. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PET/CT, prostate cancer, metastasis and staging
in
BJU International
volume
110
issue
10
pages
1501 - 1506
publisher
Blackwell Science Ltd
external identifiers
  • wos:000310477300020
  • pmid:22502982
  • scopus:84868204732
ISSN
1464-4096
DOI
10.1111/j.1464-410X.2012.11123.x
language
English
LU publication?
yes
id
2d040982-cffb-470d-b1a1-f9c77bdfda12 (old id 2519445)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22502982?dopt=Abstract
date added to LUP
2012-05-06 17:53:07
date last changed
2017-10-22 03:25:20
@article{2d040982-cffb-470d-b1a1-f9c77bdfda12,
  abstract     = {Study Type - Diagnosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Positron emission tomography/computed tomography (PET/CT) with choline and fluoride for the detection of metastases in patients with prostate cancer have each been evaluated, with mixed results. Choline PET/CT has been evaluated against pelvic lymphadenectomy, generally with a low sensitivity but a high specificity; however, the study populations have been heterogenous. Fluoride PET/CT has been evaluated against other imaging methods, such as bone scan, single photon emission CT and MRI, and has been shown to have high specificity as well as sensitivity for bone metastases, but there are no studies with biopsy verification. This is the first study that evaluates the clinical use of both choline and fluoride PET/CT on the same patients in a well-defined population of patients with high-risk prostate cancer. OBJECTIVE: • To investigate how often positron emission tomography/computed tomography (PET/CT) scans, with both (18) F-fluorocholine and (18) F-fluoride as markers, add clinically relevant information for patients with prostate cancer who have high-risk tumours and a normal or inconclusive planar bone scan. PATIENTS AND METHODS: • Patients with prostate cancer with prostate specific antigen (PSA) levels between 20 and 99 ng/mL and/or Gleason score 8-10 tumours, planned for treatment with curative intent based on routine staging with a negative or inconclusive bone scan, were further investigated with a (18) F-fluorocholine and a (18) F-fluoride PET/CT. • None of the patients received hormonal therapy before the staging procedures were completed. RESULTS: • For 50 of the 90 included patients (56%) one or both PET/CT scans indicated metastases. • (18) F-fluorocholine PET/CT indicated lymph node metastases and/or bone metastases in 35 patients (39%). • (18) F-fluoride PET/CT was suggestive for bone metastases in 37 patients (41%). • In 18 patients (20%) the PET/CT scans indicated widespread metastases, leading to a change in therapy intent from curative to non-curative. • Of the patients with positive scans, 74% had Gleason score 8-10 tumours. Of the patients with Gleason score 8-10 tumours, 64% had positive scans. CONCLUSIONS: • PET/CT scans with (18) F-fluorocholine and (18) F-fluoride commonly detect metastases in patients with high-risk prostate cancer and a negative or inconclusive bone scan. • For 20% of the patients the results of the PET/CT scans changed the treatment plan.},
  author       = {Kjölhede, Henrik and Ahlgren, Göran and Almquist, Helen and Liedberg, Fredrik and Lyttkens, Kerstin and Ohlsson, Tomas G and Bratt, Ola},
  issn         = {1464-4096},
  keyword      = {PET/CT,prostate cancer,metastasis and staging},
  language     = {eng},
  number       = {10},
  pages        = {1501--1506},
  publisher    = {Blackwell Science Ltd},
  series       = {BJU International},
  title        = {Combined (18) F-fluorocholine and (18) F-fluoride positron emission tomography/computed tomography imaging for staging of high-risk prostate cancer.},
  url          = {http://dx.doi.org/10.1111/j.1464-410X.2012.11123.x},
  volume       = {110},
  year         = {2012},
}