OBJECTIVE: Positron emission tomography (PET)/computed tomography (CT) has been shown to be a valid tool in detecting lymph node (LN) metastases in men with biochemical recurrence after radical prostatectomy. We assessed its validity in detecting a single positive LN at pathologic examination in regard to an increasing interest in lesion-targeted salvage therapies. METHODS AND MATERIALS: We included 46 patients with biochemical recurrence after radical prostatectomy and a single positive spot at [(11)C]choline PET/CT who underwent pelvic or pelvic and retroperitoneal LN dissection. The ability of [(11)C]choline PET/CT in identifying the exact positive LN was assessed with the positive predictive value (PPV) in the overall population and according to androgen deprivation therapy, prostate-specific antigen value, and site of PET/CT positivity. RESULTS: Overall, 30 patients (65%) had positive LNs at pathologic examination. Of these, only 16 (35%) had pathologically confirmed metastases in the same lymphatic region and 11 (24%) had involvement of 1 single LN. Conversely, 28 patients had positive LNs in other areas and 8 had no evidence of metastases. The overall PPV of PET/CT was 34.8% and 23.9% when exact concordance was defined according to the lymphatic landing site and single positive LN, respectively. The PPV ranged from 33.3% to 44.4% and from 17.9% to 28.6%, in men with and without androgen deprivation therapy, respectively. CONCLUSIONS: The PPV [(11)C]choline of PET/CT in correctly identifying patients with a single positive LN at salvage LN dissection is poor (24%). Therefore, extensive salvage treatment approaches are needed to maximize the chance of cure.

Passoni, N., Suardi, N., Abdollah, F., Picchio, M., Giovacchini, G., Messa, M., et al. (2014). Utility of [ 11 C]choline PET/CT in guiding lesion-targeted salvage therapies in patients with prostate cancer recurrence localized to a single lymph node at imaging: Results from a pathologically validated series. UROLOGIC ONCOLOGY, 32(1), 38.e9-38.e16 [10.1016/j.urolonc.2013.03.006].

Utility of [ 11 C]choline PET/CT in guiding lesion-targeted salvage therapies in patients with prostate cancer recurrence localized to a single lymph node at imaging: Results from a pathologically validated series

MESSA, MARIA CRISTINA;
2014

Abstract

OBJECTIVE: Positron emission tomography (PET)/computed tomography (CT) has been shown to be a valid tool in detecting lymph node (LN) metastases in men with biochemical recurrence after radical prostatectomy. We assessed its validity in detecting a single positive LN at pathologic examination in regard to an increasing interest in lesion-targeted salvage therapies. METHODS AND MATERIALS: We included 46 patients with biochemical recurrence after radical prostatectomy and a single positive spot at [(11)C]choline PET/CT who underwent pelvic or pelvic and retroperitoneal LN dissection. The ability of [(11)C]choline PET/CT in identifying the exact positive LN was assessed with the positive predictive value (PPV) in the overall population and according to androgen deprivation therapy, prostate-specific antigen value, and site of PET/CT positivity. RESULTS: Overall, 30 patients (65%) had positive LNs at pathologic examination. Of these, only 16 (35%) had pathologically confirmed metastases in the same lymphatic region and 11 (24%) had involvement of 1 single LN. Conversely, 28 patients had positive LNs in other areas and 8 had no evidence of metastases. The overall PPV of PET/CT was 34.8% and 23.9% when exact concordance was defined according to the lymphatic landing site and single positive LN, respectively. The PPV ranged from 33.3% to 44.4% and from 17.9% to 28.6%, in men with and without androgen deprivation therapy, respectively. CONCLUSIONS: The PPV [(11)C]choline of PET/CT in correctly identifying patients with a single positive LN at salvage LN dissection is poor (24%). Therefore, extensive salvage treatment approaches are needed to maximize the chance of cure.
Articolo in rivista - Articolo scientifico
Lymph node dissection; PET/CT; Prostate cancer; Recurrence; Staging;
English
12-giu-2013
2014
32
1
38.e9
38.e16
none
Passoni, N., Suardi, N., Abdollah, F., Picchio, M., Giovacchini, G., Messa, M., et al. (2014). Utility of [ 11 C]choline PET/CT in guiding lesion-targeted salvage therapies in patients with prostate cancer recurrence localized to a single lymph node at imaging: Results from a pathologically validated series. UROLOGIC ONCOLOGY, 32(1), 38.e9-38.e16 [10.1016/j.urolonc.2013.03.006].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/48887
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