Background
Methods
Patients and clinical data
n
| Mean | Range | |
---|---|---|---|
Patients (n) | 50 | ||
Age (years) | 67 | 41 to 77 | |
PSA (ng/ml) | 37 | 2.7 to 168 | |
Gleason score | 8 | 6 to 10 | |
Estimated risk of locoregional lymph node metastases (%)a | 32 | 3.3 to 80.3 |
PET/CT imaging
Evaluation of image data
SUVmax < mediastinal background | SUVmax > mediastinal background | Any visually positive uptake on PET | Pathological appearance on CT | |
---|---|---|---|---|
Low grade | + | - | ||
Intermediate grade | + | - | ||
High grade | + | + |
SUVmax<50% higher than mediastinal background | SUVmax>50% higher than mediastinal background | Any visually positive uptake on PET | Pathological appearance on CT | |
---|---|---|---|---|
Low grade | + | - | ||
Intermediate grade | + | - | ||
High grade | + | + |
Statistical analysis
Results
Distribution of positive 11C-acetate PET/CT findings
Locoregional LN localisation | High-grade suspicious LN metastases (mean SUVmaxg/ml and mean short axis mm) | Intermediate suspicious LN metastases (mean SUVmaxg/ml) | Number of patients (n=21) | Σ suspicious LN metastases |
---|---|---|---|---|
Pararectal | 6 (5.4 g/ml, 20 mm) | 0 | 4 | 6 |
Obturator | 6 (5.2 g/ml, 9.7 mm) | 2 (2.9 g/ml) | 6 | 8 |
External iliac | 28 (6.6 g/ml, 14 mm) | 36 (3.9 g/ml) | 15 | 64 |
Internal iliac | 11 (6.5 g/ml, 14 mm) | 4 (4.7 g/ml) | 9 | 15 |
Common iliac | 7 (4.8 g/ml, 13 mm) | 5 (4.3 g/ml) | 6 | 12 |
Σ | 58 | 47 | 21a | 105 |
Localisation of suspected pathology | Number of PET + lesions | Number of CT + lesions | CT appearance | Pathology unrelated to prostate cancer | Number of patients | Σ distant metastases |
---|---|---|---|---|---|---|
Paraaortal LN | 6 (mean SUVmax 5.8 g/ml) | 6 (mean short axis 13 mm) | Oval-rounded shape | 6 | 6 (4 solitary, 2 conglomerates) | |
Mediastinal/hilar LN | 8 (mean SUVmax 3.7 g/ml) | 8 (mean short axis 10 mm) | Oval-rounded shape | 8 | 8 (6 solitary, 2 conglomerates) | |
Axillary LN | 1 (SUVmax 9.0 g/ml) | 1 (short axis 10 mm) | Rounded shape | 1 | 1 | |
Cervical LN | 2 (mean SUVmax 5.6 g/ml) | 2 (mean short axis 10 mm) | Rounded shape | 1 | 2 (2 conglomerates) | |
Skeletal | 20 (mean SUVmax 7.1 g/ml) | 20 | Sclerotic | 4 | 20 | |
Liver | 1 (SUVmax 14.3 g/ml) | 1 | Hypoattenuating mass | HCC | 1 | - |
Kidney | 1 (SUVmax 14.2 g/ml) | 1 | Heterogeneous mass | RCC | 1 | - |
Σ | 39 | 39 | 22a | 37 |
Association between 11C-acetate PET/CT findings and the estimated risk of locoregional lymph node metastases
Prognostic value of prostate SUVmax
Impact of 11C-acetate PET/CT findings on treatment strategy
Patient number | Localisation pelvic LN metastases | Localisation distant metastases | Synchronous finding | Curative→additional RT | Curative→non-curative RT |
---|---|---|---|---|---|
1 | Iliac int/ext | Paraaortal LN | - | - | Palliative RT |
2 | Iliac ext | Skeletal | - | - | No RT |
3 | Iliac int/ext | - | - | RT boost 16 Gy | - |
4 | Iliac int/ext | - | RT boost 16 Gy | - | |
5 | Iliac ext | - | - | RT boost 16 Gy | - |
6 | Iliac com | - | RT boost 16 Gy | - | |
7 | Iliac int/ext | - | - | RT boost 16 Gy | - |
8 | Obt, iliac int/ext/com | - | RT boost 15 Gy | - | |
9 | - | - | HCC with paraaortal LN | - | No RT |
10 | Iliac ext | - | RT boost 20 Gy | - | |
11 | Obt, iliac int/ext/com | Paraaortal LN, skeletal | - | - | No RT |
12 | Pararectal, iliac ext | - | - | RT boost 26 Gy | - |
13 | Pararectal, obt, iliac int/ext/com | Paraaortal LN | - | - | Palliative RT |
14 | Iliac int/ext/com | Paraaortal, thoracic, cervical LN | - | - | No RT |
15 | - | Skeletal | - | - | No RT |
16 | Iliac ext | - | - | RT boost 16 Gy | - |
17 | Iliac ext | Skeletal | - | - | No RT |
18 | - | - | Aortic aneurysm | - | No RT |
19 | Pararectal, iliac int/ext/com | Paraaortal, thoracic LN | - | - | No RT |
20 | Pararectal, obt, iliac ext | - | - | - | Palliative RT |
Σ | 17 | 8 | 2 | 9 | 11 |
Estimated risk | Addition of RT boost to pelvic LN | Change to no/palliative RT |
---|---|---|
≤45% (n =11) | 4 | 7 |
>45% (n =9) | 5 | 4 |