Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
European Journal of Nuclear Medicine and Molecular Imaging
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 13/2017

12.08.2017 | Original Article

Prospective head-to-head comparison of 11C-choline-PET/MR and 11C-choline-PET/CT for restaging of biochemical recurrent prostate cancer

verfasst von: Matthias Eiber, Isabel Rauscher, Michael Souvatzoglou, Tobias Maurer, Markus Schwaiger, Konstantin Holzapfel, Ambros J. Beer

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 13/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Whole-body integrated 11C-choline PET/MR might provide advantages compared to 11C-choline PET/CT for restaging of prostate cancer (PC) due to the high soft-tissue contrast and the use of multiparametric MRI, especially for detection of local recurrence and bone metastases.

Materials and methods

Ninety-four patients with recurrent PC underwent a single-injection/dual-imaging protocol with contrast-enhanced PET/CT followed by fully diagnostic PET/MR. Imaging datasets were read separately by two reader teams (team 1 and 2) assessing the presence of local recurrence, lymph node and bone metastases in predefined regions using a five-point scale. Detection rates were calculated. The diagnostic performance of PET/CT vs. PET/MR was compared using ROC analysis. Inter-observer and inter-modality variability, radiation exposure, and mean imaging time were evaluated. Clinical follow-up, imaging, and/or histopathology served as standard of reference (SOR).

Results

Seventy-five patients qualified for the final image analysis. A total of 188 regions were regarded as positive: local recurrence in 37 patients, 87 regions with lymph node metastases, and 64 regions with bone metastases. Mean detection rate between both readers teams for PET/MR was 84.7% compared to 77.3% for PET/CT (p > 0.05). Local recurrence was identified significantly more often in PET/MR compared to PET/CT by team 1. Lymph node and bone metastases were identified significantly more often in PET/CT compared to PET/MR by both teams. However, this difference was not present in the subgroup of patients with PSA values ≤2 ng/ml.
Inter-modality and inter-observer agreement (K > 0.6) was moderate to substantial for nearly all categories. Mean reduction of radiation exposure for PET/MR compared to PET/CT was 79.7% (range, 72.6–86.2%). Mean imaging time for PET/CT was substantially lower (18.4 ± 0.7 min) compared to PET/MR (50.4 ± 7.9 min).

Conclusions

11C-choline PET/MR is a robust imaging modality for restaging biochemical recurrent PC and interpretations between different readers are consistent. It provides a higher diagnostic value for detecting local recurrence compared to PET/CT with the advantage of substantial dose reduction. Drawbacks of PET/MR are a substantially longer imaging time and a slight inferiority in detecting bone and lymph node metastases in patients with PSA values >2 ng/ml. Thus, we suggest the use of 11C-choline PET/MR especially for patients with low (≤2 ng/ml) PSA values, whereas PET/CT is preferable in the subgroup with higher PSA values.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed
2.
3.
Freedland SJ, Presti JC Jr, Amling CL, et al. Time trends in biochemical recurrence after radical prostatectomy: results of the SEARCH database. Urology. 2003;61:736–41.CrossRefPubMed
4.
Han M, Partin AW, Zahurak M, Piantadosi S, Epstein JI, Walsh PC. Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol. 2003;169:517–23.CrossRefPubMed
5.
Chism DB, Hanlon AL, Horwitz EM, Feigenberg SJ, Pollack A. A comparison of the single and double factor high-risk models for risk assignment of prostate cancer treated with 3D conformal radiotherapy. Int J Radiat Oncol Biol Phys. 2004;59:380–5.CrossRefPubMed
6.
Krause BJ, Souvatzoglou M, Tuncel M, et al. The detection rate of [11C]choline-PET/CT depends on the serum PSA value in patients with biochemical recurrence of prostate cancer. Eur J Nucl Med Mol Imaging. 2008;35:18–23.CrossRefPubMed
7.
de Jong IJ, Pruim J, Elsinga PH, Vaalburg W, Mensink HJ. Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET. J Nucl Med. 2003;44:331–5.PubMed
8.
Krause BJ, Souvatzoglou M, Treiber U. Imaging of prostate cancer with PET/CT and radioactively labeled choline derivates. Urol Oncol. 2013;31:427–35.CrossRefPubMed
9.
Beer AJ, Eiber M, Souvatzoglou M, Schwaiger M, Krause BJ. Radionuclide and hybrid imaging of recurrent prostate cancer. Lancet Oncol. 2011;12:181–91.CrossRefPubMed
10.
Castellucci P, Fuccio C, Nanni C, et al. Influence of trigger PSA and PSA kinetics on 11C-choline PET/CT detection rate in patients with biochemical relapse after radical prostatectomy. J Nucl Med. 2009;50:1394–400.CrossRefPubMed
11.
Giovacchini G, Picchio M, Coradeschi E, et al. [(11)C]choline uptake with PET/CT for the initial diagnosis of prostate cancer: relation to PSA levels, tumour stage and anti-androgenic therapy. Eur J Nucl Med Mol Imaging. 2008;35:1065–73.CrossRefPubMed
12.
Evangelista L, Briganti A, Fanti S, et al. New clinical indications for (18)F/(11)C-choline, new tracers for positron emission tomography and a promising hybrid device for prostate cancer staging: a systematic review of the literature. Eur Urol. 2016;70:161–75.CrossRefPubMed
13.
Heidenreich A, Bastian PJ, Bellmunt J, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2013;65:124–37.CrossRefPubMed
14.
Seemann MD. Whole-body PET/MRI: the future in oncological imaging. Technol Cancer Res Treat. 2005;4:577–82.CrossRefPubMed
15.
Antoch G, Bockisch A. Combined PET/MRI: a new dimension in whole-body oncology imaging? Eur J Nucl Med Mol Imaging. 2009;36(Suppl 1):S113–20.CrossRefPubMed
16.
Boonsirikamchai P, Choi S, Frank SJ, et al. MR imaging of prostate cancer in radiation oncology: what radiologists need to know. Radiographics. 2013;33:741–61.CrossRefPubMed
17.
Vargas HA, Wassberg C, Akin O, Hricak H. MR imaging of treated prostate cancer. Radiology. 2012;262:26–42.CrossRefPubMed
18.
Kim CK, Park BK, Lee HM. Prediction of locally recurrent prostate cancer after radiation therapy: incremental value of 3T diffusion-weighted MRI. J Magn Reson Imaging. 2009;29:391–7.CrossRefPubMed
19.
Haider MA, Chung P, Sweet J, et al. Dynamic contrast-enhanced magnetic resonance imaging for localization of recurrent prostate cancer after external beam radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70:425–30.CrossRefPubMed
20.
Eiber M, Takei T, Souvatzoglou M, et al. Performance of whole-body integrated 18F-FDG PET/MR in comparison to PET/CT for evaluation of malignant bone lesions. J Nucl Med. 2014;55:191–7.CrossRefPubMed
21.
Rauscher I, Eiber M, Furst S, et al. PET/MR imaging in the detection and characterization of pulmonary lesions: technical and diagnostic evaluation in comparison to PET/CT. J Nucl Med. 2014;55:724–9.CrossRefPubMed
22.
Bailey DL, Pichler BJ, Guckel B, et al. Combined PET/MRI: multi-modality multi-parametric imaging is here: summary report of the 4th international workshop on PET/MR imaging; February 23-27, 2015, Tubingen, Germany. Mol Imaging Biol. 2015;17:595–608.CrossRefPubMed
23.
Delso G, Furst S, Jakoby B, et al. Performance measurements of the Siemens mMR integrated whole-body PET/MR scanner. J Nucl Med. 2011;52:1914–22.CrossRefPubMed
24.
Drzezga A, Souvatzoglou M, Eiber M, et al. First clinical experience with integrated whole-body PET/MR: comparison to PET/CT in patients with oncologic diagnoses. J Nucl Med. 2012;53:845–55.CrossRefPubMed
25.
Tolvanen T, Yli-Kerttula T, Ujula T, et al. Biodistribution and radiation dosimetry of [(11)C]choline: a comparison between rat and human data. Eur J Nucl Med Mol Imaging. 2010;37:874–83.CrossRefPubMed
26.
27.
European Guidelines on Quality Criteria for Computed Tomography. Report EUR 16262. Brussels, Belgium: European Commission; 1999.
28.
Brix G, Lechel U, Glatting G, et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med. 2005;46:608–13.PubMed
29.
Huda W, Magill D, He W. CT effective dose per dose length product using ICRP 103 weighting factors. Med Phys. 2011;38:1261–5.CrossRefPubMed
30.
Svanholm H, Starklint H, Gundersen HJ, Fabricius J, Barlebo H, Olsen S. Reproducibility of histomorphologic diagnoses with special reference to the kappa statistic. APMIS. 1989;97:689–98.CrossRefPubMed
31.
Tuncel M, Souvatzoglou M, Herrmann K, et al. [(11)C]choline positron emission tomography/computed tomography for staging and restaging of patients with advanced prostate cancer. Nucl Med Biol. 2008;35:689–95.CrossRefPubMed
32.
Souvatzoglou M, Eiber M, Takei T, et al. Comparison of integrated whole-body [11C]choline PET/MR with PET/CT in patients with prostate cancer. Eur J Nucl Med Mol Imaging. 2013;40:1486–99.CrossRefPubMed
33.
Wetter A, Lipponer C, Nensa F, et al. Simultaneous 18F choline positron emission tomography/magnetic resonance imaging of the prostate: initial results. Investig Radiol. 2013;48:256–62.CrossRef
34.
Wetter A, Lipponer C, Nensa F, et al. Quantitative evaluation of bone metastases from prostate cancer with simultaneous [18F] choline PET/MRI: combined SUV and ADC analysis. Ann Nucl Med. 2014;28:405–10.CrossRefPubMed
35.
Wetter A, Nensa F, Schenck M, et al. Combined PET imaging and diffusion-weighted imaging of intermediate and high-risk primary prostate carcinomas with simultaneous [18F] choline PET/MRI. PLoS One. 2014;9:e101571.CrossRefPubMedPubMedCentral
36.
Kitajima K, Murphy RC, Nathan MA, et al. Detection of recurrent prostate cancer after radical prostatectomy: comparison of 11C-choline PET/CT with pelvic multiparametric MR imaging with endorectal coil. J Nucl Med. 2014;55:223–32.CrossRefPubMed
37.
Roy C, Foudi F, Charton J, et al. Comparative sensitivities of functional MRI sequences in detection of local recurrence of prostate carcinoma after radical prostatectomy or external-beam radiotherapy. AJR Am J Roentgenol. 2013;200:W361–8.CrossRefPubMed
38.
Panebianco V, Sciarra A, Lisi D, et al. Prostate cancer: 1HMRS-DCEMR at 3T versus [(18)F]choline PET/CT in the detection of local prostate cancer recurrence in men with biochemical progression after radical retropubic prostatectomy (RRP). Eur J Radiol. 2012;81:700–8.CrossRefPubMed
39.
Hovels AM, Heesakkers RA, Adang EM, et al. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol. 2008;63:387–95.CrossRefPubMed
40.
Scattoni V, Picchio M, Suardi N, et al. Detection of lymph-node metastases with integrated [11C]choline PET/CT in patients with PSA failure after radical retropubic prostatectomy: results confirmed by open pelvic-retroperitoneal lymphadenectomy. Eur Urol. 2007;52:423–9.CrossRefPubMed
41.
Brauck K, Zenge MO, Vogt FM, et al. Feasibility of whole-body MR with T2- and T1-weighted real-time steady-state free precession sequences during continuous table movement to depict metastases. Radiology. 2008;246:910–6.CrossRefPubMed
42.
Fendler WP, Barrio M, Spick C, et al. 68Ga-DOTATATE PET/CT interobserver agreement for neuroendocrine tumor assessments: results of a prospective study on 50 patients. J Nucl Med. 2017;58(2):307–11.
43.
Ruf J, Schiefer J, Furth C, et al. 68Ga-DOTATOC PET/CT of neuroendocrine tumors: spotlight on the CT phases of a triple-phase protocol. J Nucl Med. 2011;52:697–704.CrossRefPubMed
44.
Muller BG, Shih JH, Sankineni S, et al. Prostate cancer: Interobserver agreement and accuracy with the revised prostate imaging reporting and data system at multiparametric MR imaging. Radiology. 2015;277:741–50.CrossRefPubMedPubMedCentral
45.
Senft A, de Bree R, Golding RP, et al. Interobserver variability in chest CT and whole body FDG-PET screening for distant metastases in head and neck cancer patients. Mol Imaging Biol. 2010;13:385–90.CrossRefPubMedCentral
46.
Thureau S, Chaumet-Riffaud P, Modzelewski R, et al. Interobserver agreement of qualitative analysis and tumor delineation of 18F-fluoromisonidazole and 3′-deoxy-3′-18F-fluorothymidine PET images in lung cancer. J Nucl Med. 2013;54:1543–50.CrossRefPubMed
47.
Freitag MT, Radtke JP, Hadaschik BA, et al. Comparison of hybrid (68)Ga-PSMA PET/MRI and (68)Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43:70–83.CrossRefPubMed
Metadaten
Titel
Prospective head-to-head comparison of 11C-choline-PET/MR and 11C-choline-PET/CT for restaging of biochemical recurrent prostate cancer
verfasst von
Matthias Eiber
Isabel Rauscher
Michael Souvatzoglou
Tobias Maurer
Markus Schwaiger
Konstantin Holzapfel
Ambros J. Beer
Publikationsdatum
12.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 13/2017
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-017-3797-y

Weitere Artikel der Ausgabe 13/2017

European Journal of Nuclear Medicine and Molecular Imaging 13/2017 Zur Ausgabe

Original Article

TSPO PET for glioma imaging using the novel ligand 18F-GE-180: first results in patients with glioblastoma

Original Article

Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection

Editorial

TSPO PET using 18F-GE-180: a new perspective in neurooncology?

Original Article

A pilot study for texture analysis of 18F-FDG and 18F-FLT-PET/CT to predict tumor recurrence of patients with colorectal cancer who received surgery

Original Article

Additive value of amyloid-PET in routine cases of clinical dementia work-up after FDG-PET

Letter to the Editor

Reply to: Laffon and Marthan “FDG PET for therapy monitoring in Hodgkin’s and non-Hodgkin’s lymphomas: qPET versus rPET”