The Use of F-18 Choline PET in the Assessment of Bone Metastases in Prostate Cancer: Correlation with Morphological Changes on CT
The Use of F-18 Choline PET in the Assessment of Bone Metastases in Prostate Cancer: Correlation with Morphological Changes on CT
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DOI：
10.1007/s11307-009-0239-7
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发表时间：
2010-02-01
影响因子：
3.1
通讯作者：
Langsteger, Werner
中科院分区：
文献类型：
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作者：
Beheshti, Mohsen;Vali, Reza;Langsteger, Werner
F-18荧光胆碱正电子发射断层扫描/计算机断层扫描（FCH-PET/CT）已成为前列腺癌成像的新诊断工具。在这项研究中，我们评估了FCH-PET/CT在评估前列腺癌患者骨转移中的潜在作用。此外，我们评估了FCH的代谢吸收模式与CT形态学变化的关系。70例经活检证实的前列腺癌患者接受了FCH-PET/CT术前分期或随访评估。32例患者接受术前评价，38例患者根据临床算法接受疑似复发或进展的术后评价。PET成像包括在静脉注射4.07 MBq/kg/bw FCH后1分钟开始的8分钟内（1分钟帧）盆腔区域的动态PET/CT采集，随后立即进行半全身采集。210个病变（262个中的210个）被解释为骨转移。所有恶性病变的最大标准化摄取值（SUVmax）平均值为8.1 ± 3.9。49个病灶（24%）在CT上没有可检测到的形态学变化，可能是由于骨髓转移。五十六例骨转移性病变（Hounsfield单位（HU）水平大于825）在CT和/或其他成像方式（如骨扫描）上被解释为高度可疑骨转移性疾病，但未显示FCH摄取。SUV法测定的示踪剂摄取量与HU法测定的病灶密度呈显著相关（r =-0.52，P < 0.001）。FCH-PET/CT诊断前列腺癌骨转移的敏感性、特异性和准确性分别为79%、97%和84%，对前列腺癌骨转移的早期诊断具有重要意义。我们已经发现，高于825的HU水平与FCH摄取的缺乏相关。几乎所有的FCH阴性sclerosis病变都是在接受激素治疗的患者中检测到的，这增加了这些病变可能不再存活的可能性。然而，这种病变的澄清和预后价值需要进一步的研究。
F-18 fluor choline-positron emission tomography/computed tomography (FCH-PET/CT) has emerged as a new diagnostic tool for the imaging of prostate cancer. In this study, we have evaluated the potential role of FCH-PET/CT for the assessment of bone metastases in patients with prostate cancer. Furthermore, we assessed the pattern of metabolic uptake by FCH in relation to morphologic changes on CT.Seventy men with biopsy-proven prostate cancer underwent FCH-PET/CT for preoperative staging or follow-up evaluation. Thirty-two patients were evaluated preoperatively, and 38 patients were referred for postoperative evaluation of suspected recurrence or progression based on clinical algorithms. PET imaging consisted of a dynamic PET/CT acquisition of the pelvic region during 8 min (1 min frames) starting 1 min after i.v. injection of 4.07 MBq/kg/bw FCH, which was followed immediately by a semi-whole body acquisition.Overall, 262 lesions showed increased uptake on FCH-PET. Two hundred ten lesions (210 of 262) were interpreted as bone metastases. The mean of maximum standardized uptake value (SUVmax) in all malignant lesions was 8.1 +/- 3.9. Forty-nine lesions (24%) had no detectable morphological changes on CT-probably due to bone marrow metastases. Fifty-six sclerotic lesions (having a Hounsfield unit (HU) level of more than 825) were interpreted as highly suspicious for metastatic bone disease on CT and/or other imaging modalities such as the bone scan, but showed no FCH uptake. There was a significant correlation between tracer uptake as assessed by SUV and the density of sclerotic lesions by HU (r = -0.52, p < 0.001). The sensitivity, specificity, and accuracy of FCH-PET/CT in detecting bone metastases from prostate cancer was 79%, 97%, and 84%, respectively.FCH-PET/CT showed promising results for the early detection of bone metastases in prostate cancer patients. We have found that a HU level of above 825 is associated with an absence of FCH uptake. Almost all of the FCH-negative sclerotic lesions were detected in patients who were under hormone therapy, which raises the possibility that these lesions might no longer be viable. However, clarification and the prognostic value of such lesions require further research.