OBJECTIVES: To prospectively evaluate the accuracy of integrated [(11)C]choline-PET/CT in the diagnosis of lymph-node recurrence in prostate cancer patients with biochemical failure after surgery. METHODS: Since October 2002, 25 patients with biochemical recurrence (median PSA: 1.98ng/ml), based on evidence of lymph-node metastases on [(11)C]choline-PET/CT scan (21 cases) or conventional imaging (4 cases), were scheduled for either bilateral pelvic (12 cases) or both pelvic and retroperitoneal lymph-node dissection (13 patients). RESULTS: Sixty-three nodal sites were evaluated histologically. The mean number of nodes removed and positive nodes were 21.92+/-16.91 (range: 4-74) and 8.84+/-9.65 (range: 1-31), respectively. Of the four patients with negative [(11)C]choline-PET/CT and positive magnetic resonance, none had nodal metastases. Nineteen of the 21 patients (90%) with positive [(11)C]choline-PET/CT had nodal metastases of prostate adenocarcinoma at histologic evaluation. A lesion-based analysis showed that [(11)C]choline-PET/CT sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 64%, 90%, 86%, 72%, and 77%, respectively. The mean maximum diameter of true positive metastases was larger than false-negative ones (15.0 vs. 6.3mm; p=0.0004). CONCLUSIONS: [(11)C]Choline-PET/CT is an accurate diagnostic tool for the detection of lymph-node metastases of recurrent prostate cancer. The low negative predictive value seems to depend on the limited capability of [(11)C]choline-PET/CT to detect microscopic lesions. The high positive predictive value, even with low PSA values, provides a basis for further treatment decisions.

Scattoni, V., Picchio, M., Suardi, N., Messa, M., Freschi, M., Roscigno, M., et al. (2007). Detection of Lymph-Node Metastases with Integrated [(11)C]Choline PET/CT in Patients with PSA Failure after Radical Retropubic Prostatectomy: Results Confirmed by Open Pelvic-Retroperitoneal Lymphadenectomy. EUROPEAN UROLOGY, 52(2), 523-529 [10.1016/j.eururo.2007.03.032].

Detection of Lymph-Node Metastases with Integrated [(11)C]Choline PET/CT in Patients with PSA Failure after Radical Retropubic Prostatectomy: Results Confirmed by Open Pelvic-Retroperitoneal Lymphadenectomy

MESSA, MARIA CRISTINA;Da Pozzo, L;FAZIO, FERRUCCIO
2007

Abstract

OBJECTIVES: To prospectively evaluate the accuracy of integrated [(11)C]choline-PET/CT in the diagnosis of lymph-node recurrence in prostate cancer patients with biochemical failure after surgery. METHODS: Since October 2002, 25 patients with biochemical recurrence (median PSA: 1.98ng/ml), based on evidence of lymph-node metastases on [(11)C]choline-PET/CT scan (21 cases) or conventional imaging (4 cases), were scheduled for either bilateral pelvic (12 cases) or both pelvic and retroperitoneal lymph-node dissection (13 patients). RESULTS: Sixty-three nodal sites were evaluated histologically. The mean number of nodes removed and positive nodes were 21.92+/-16.91 (range: 4-74) and 8.84+/-9.65 (range: 1-31), respectively. Of the four patients with negative [(11)C]choline-PET/CT and positive magnetic resonance, none had nodal metastases. Nineteen of the 21 patients (90%) with positive [(11)C]choline-PET/CT had nodal metastases of prostate adenocarcinoma at histologic evaluation. A lesion-based analysis showed that [(11)C]choline-PET/CT sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 64%, 90%, 86%, 72%, and 77%, respectively. The mean maximum diameter of true positive metastases was larger than false-negative ones (15.0 vs. 6.3mm; p=0.0004). CONCLUSIONS: [(11)C]Choline-PET/CT is an accurate diagnostic tool for the detection of lymph-node metastases of recurrent prostate cancer. The low negative predictive value seems to depend on the limited capability of [(11)C]choline-PET/CT to detect microscopic lesions. The high positive predictive value, even with low PSA values, provides a basis for further treatment decisions.
Articolo in rivista - Articolo scientifico
Prostate cancer,Radical retropubic, prostatectomy, Positron emission, tomography, Computed tomography, [11C]Choline,
English
2007
52
2
523
529
none
Scattoni, V., Picchio, M., Suardi, N., Messa, M., Freschi, M., Roscigno, M., et al. (2007). Detection of Lymph-Node Metastases with Integrated [(11)C]Choline PET/CT in Patients with PSA Failure after Radical Retropubic Prostatectomy: Results Confirmed by Open Pelvic-Retroperitoneal Lymphadenectomy. EUROPEAN UROLOGY, 52(2), 523-529 [10.1016/j.eururo.2007.03.032].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/2000
Citazioni
  • Scopus 234
  • ???jsp.display-item.citation.isi??? 210
Social impact