Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer
Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer
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DOI：
10.1007/s00259-007-0552-9
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发表时间：
2008-02-01
影响因子：
9.1
通讯作者：
Hany, Thomas F.
中科院分区：
文献类型：
--
作者：
Husarik, Daniela B.;Miralbell, Raymond;Hany, Thomas F.
目的评价18氟胆碱（FCH）正电子发射断层扫描/计算机断层扫描（PET/CT）对前列腺癌分期和再分期的准确性。平均前列腺特异性抗原（PSA）11.58 μ g/l]进行了初始分期检查，68例患者（平均年龄66.4岁）进行了再分期检查（平均PSA 10.81 μ g/l）。FCH PET/CT结果与组织病理学，骨扫描，形态学所揭示的磁共振成像（MRI）和CT，PET/CT随访和PSA随访后therapeutic.Results FCH PET/CT扫描在初始分期正确显示无转移36/38例患者接受根治性手术，证实术后6个月PSA水平< 0.1 μ g/L。其中24例患者行淋巴结切除术，发现4个假FCH阴性淋巴结（LN）。在一名患者中，仅进行淋巴结切除术，因为FCH阳性LN经组织学证实。骨扫描证实4例FCH阳性骨转移。再分期时的FCH PET/CT扫描正确显示36例患者局部复发。在11例生化复发患者中未观察到病理性FCH摄取。23例FCH阳性LN。7例患者手术切除20例LN。组织学检查证实所有淋巴结转移，但发现两个额外的恶性，FCH阴性淋巴结。17例患者显示FCH阳性骨转移，经骨扫描或MRI证实。结论FCH PET/CT对原发性肝癌的N分期结果不理想，尤其是对微小转移灶的检出率较低。PSA水平> 2 μ g/l的患者可以可靠地定位复发性疾病。
Purpose To evaluate the accuracy of [F-18]-choline (FCH) positron emission tomography/computed tomography (PET/CT) for staging and restaging of prostate cancer.Methods FCH PET/CT was performed in 111 patients with prostate cancer using 200 MBq FCH: 43 patients [mean age 63 years; mean prostrate specific antigen (PSA) 11.58 mu g/l] were examined for initial staging, and 68 patients (mean age 66.4 years) were examined for restaging (mean PSA 10.81 mu g/l). FCH PET/CT results were correlated to histopathology, bone scan, morphology as revealed by magnetic resonance imaging (MRI) and CT, PET/CT follow-up and PSA follow-up after therapy.Results FCH PET/CT scans at initial staging correctly showed no metastases in 36/38 patients undergoing radical surgery, as confirmed by PSA levels < 0.1 mu g/l 6 months postoperatively. Lymphadenectomy was performed in 24 of these patients, revealing four false FCH-negative lymph nodes (LN). In one patient, only lymphadenectomy was performed since a FCH-positive LN was confirmed by histology. Four patients showed FCH-positive bone metastases, as proven by bone scan. FCH PET/CT scans at restaging correctly revealed local recurrence in 36 patients. No pathological FCH uptake was observed in 11 patients with biochemical recurrence. Twenty-three patients showed FCH-positive LN. Twenty LN were surgically removed in seven patients. Histopathology verified metastases in all LN, but revealed two additional metastastic, FCH-negative LN. Seventeen patients showed FCH-positive bone metastases, as proven by bone scan or MRI. Sensitivity to detect recurrent disease was 86%.Conclusion The results obtained using FCH PET/CT scans for initial N-staging were discouraging, especially in terms of its inability to detect small metastases. Recurrent disease can be localized reliably in patients with PSA levels of > 2 mu g/l.