To evaluate the accuracy of contrast-enhanced F-18-choline PET/CT in restaging patients with prostate cancer after radical prostatectomy in relation to PSA, PSA velocity (PSAve) and PSA doubling time (PSAdt). PET/CT was performed in 49 patients (age range 58-87 years) with rising PSA (mean 4.13 ng/ml) who were divided in four groups according to PSA level: a parts per thousand currency sign1 ng/ml, 1 to a parts per thousand currency sign2 ng/ml, 2 to a parts per thousand currency sign4 ng/ml, and > 4 ng/ml. PSAve and PSAdt were measured. PET and CT scans were interpreted separately and then together. PET/CT diagnosed relapse in 33 of the 49 patients (67%). The detection rates were 20%, 55%, 80% and 87% in the PSA groups a parts per thousand currency sign1, 1 to a parts per thousand currency sign2, 2 to a parts per thousand currency sign4 and > 4 ng/ml, respectively. PET/CT was positive in 7 of 18 patients (38.9%) with a PSA a parts per thousand currency sign2 ng/ml, and in 26 of 31 (83.9%) with a PSA > 2 ng/ml. PET/CT was positive in 7 of 25 patients (84%) with PSAdt a parts per thousand currency sign6 months, and in 12 of 24 patients (50%) with PSAdt > 6 months, and was positive in 26 of 30 patients (86%) with a PSAve > 2 ng/ml per year, and in 7 of 19 patients (36.8%) with PSAve a parts per thousand currency sign2 ng/ml per year. PET alone was positive in 31 of 49 patients (63.3%), and of these 31 patients, CT was negative in 14 but diagnosed bone lesions in 2 patients in whom PET alone was negative. CT with the administration of intravenous contrast medium did not provide any further information. Detection rate of F-18-choline imaging is closely related to PSA and PSA kinetics. In particular, F-18-choline PET/CT is recommended in patients with PSA > 2 ng/ml, PSAdt a parts per thousand currency sign6 months and PSAve > 2 ng/ml per year. CT is useful for detecting bone metastases that are not F-18-choline-avid. The use of intravenous contrast agent seems unnecessary.

Influence of PSA, PSA velocity and PSA doubling time on contrast-enhanced F-18-choline PET/CT detection rate in patients with rising PSA after radical prostatectomy

Danieli R;
2012

Abstract

To evaluate the accuracy of contrast-enhanced F-18-choline PET/CT in restaging patients with prostate cancer after radical prostatectomy in relation to PSA, PSA velocity (PSAve) and PSA doubling time (PSAdt). PET/CT was performed in 49 patients (age range 58-87 years) with rising PSA (mean 4.13 ng/ml) who were divided in four groups according to PSA level: a parts per thousand currency sign1 ng/ml, 1 to a parts per thousand currency sign2 ng/ml, 2 to a parts per thousand currency sign4 ng/ml, and > 4 ng/ml. PSAve and PSAdt were measured. PET and CT scans were interpreted separately and then together. PET/CT diagnosed relapse in 33 of the 49 patients (67%). The detection rates were 20%, 55%, 80% and 87% in the PSA groups a parts per thousand currency sign1, 1 to a parts per thousand currency sign2, 2 to a parts per thousand currency sign4 and > 4 ng/ml, respectively. PET/CT was positive in 7 of 18 patients (38.9%) with a PSA a parts per thousand currency sign2 ng/ml, and in 26 of 31 (83.9%) with a PSA > 2 ng/ml. PET/CT was positive in 7 of 25 patients (84%) with PSAdt a parts per thousand currency sign6 months, and in 12 of 24 patients (50%) with PSAdt > 6 months, and was positive in 26 of 30 patients (86%) with a PSAve > 2 ng/ml per year, and in 7 of 19 patients (36.8%) with PSAve a parts per thousand currency sign2 ng/ml per year. PET alone was positive in 31 of 49 patients (63.3%), and of these 31 patients, CT was negative in 14 but diagnosed bone lesions in 2 patients in whom PET alone was negative. CT with the administration of intravenous contrast medium did not provide any further information. Detection rate of F-18-choline imaging is closely related to PSA and PSA kinetics. In particular, F-18-choline PET/CT is recommended in patients with PSA > 2 ng/ml, PSAdt a parts per thousand currency sign6 months and PSAve > 2 ng/ml per year. CT is useful for detecting bone metastases that are not F-18-choline-avid. The use of intravenous contrast agent seems unnecessary.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.12078/819
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