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European Radiology

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01.08.2014 | Urogenital

Preoperative lymph node staging in patients with primary prostate cancer: comparison and correlation of quantitative imaging parameters in diffusion-weighted imaging and 11C-choline PET/CT

Erschienen in: European Radiology | Ausgabe 8/2014

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Abstract

Purpose

To compare the diagnostic performance of DWI and 11C-choline PET/CT in the assessment of preoperative lymph node status in patients with primary prostate cancer.

Material and methods

Thirty-three patients underwent DWI and 11C-choline PET/CT prior to prostatectomy and extended pelvic lymph node dissection. Mean standardised uptake value (SUV_mean) and mean apparent diffusion coefficient (ADC) of 76 identified lymph nodes (LN) were measured and correlated with histopathology. ADC values and SUVs were compared using linear regression analysis.

Results

A significant difference between benign and malignant LN was observed for ADC values (1.17 vs. 0.96 × 10^-3 mm²/s; P < 0.001) and SUV_mean (1.61 vs. 3.20; P < 0.001). ROC analysis revealed an optimal ADC threshold of 1.01 × 10^-3 mm²/s for differentiating benign from malignant LN with corresponding sensitivity/specificity of 69.70 %/78.57 % and an area under the curve (AUC) of 0.785. The optimal threshold for SUV_mean was 2.5 with corresponding sensitivity/specificity of 69.72 %/90.48 % and with an AUC of 0.832. ADC values and SUV_mean showed a moderate significant inverse correlation (r = -0.63).

Conclusion

Both modalities reveal similar moderate diagnostic performance for preoperative lymph node staging of prostate cancer, not justifying their application in routine clinical practice at this time. The only moderate inverse correlation between ADC values and SUV_mean suggests that both imaging parameters might provide complementary information on tumour biology.

Key Points

• Conventional imaging shows low performance for lymph node staging in prostate cancer.

• DWI and 11C-choline PET/CT both provide additional functional information

• Both functional modalities reveal only moderate diagnostic performance.

De Jong IJ, Pruim J, Elsinga PH et al (2003) Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET. J Nucl Med Off Publ Soc Nucl Med 44:331–335

Wang L, Hricak H, Kattan MW et al (2006) Combined endorectal and phased-array MRI in the prediction of pelvic lymph node metastasis in prostate cancer. AJR Am J Roentgenol 186:743–748PubMedCrossRef

Borley N, Fabrin K, Sriprasad S et al (2003) Laparoscopic pelvic lymph node dissection allows significantly more accurate staging in “high-risk” prostate cancer compared to MRI or CT. Scand J Urol Nephrol 37:382–386PubMedCrossRef

Vandecaveye V, De Keyzer F, Vander Poorten V et al (2009) Head and neck squamous cell carcinoma: value of diffusion-weighted MR imaging for nodal staging. Radiology 251:134–146PubMedCrossRef

Eiber M, Beer AJ, Holzapfel K et al (2010) Preliminary results for characterization of pelvic lymph nodes in patients with prostate cancer by diffusion-weighted MR-imaging. Investig Radiol 45:15–23CrossRef

Klerkx WM, Mali WM, Peter Heintz A et al (2011) Observer variation of magnetic resonance imaging and diffusion weighted imaging in pelvic lymph node detection. Eur J Radiol 78:71–74PubMedCrossRef

Beer AJ, Eiber M, Souvatzoglou M et al (2011) Restricted water diffusibility as measured by diffusion-weighted MR imaging and choline uptake in (11)C-choline PET/CT are correlated in pelvic lymph nodes in patients with prostate cancer. Mol Imaging Biol MIB Off Publ Acad Mol Imaging 13:352–361CrossRef

Budiharto T, Joniau S, Lerut E et al (2011) Prospective evaluation of 11C-choline positron emission tomography/computed tomography and diffusion-weighted magnetic resonance imaging for the nodal staging of prostate cancer with a high risk of lymph node metastases. Eur Urol 60:125–130PubMedCrossRef

Schwarzenböck S, Souvatzoglu M, Krause BJ (2012) Choline PET and PET/CT in Primary Diagnosis and Staging of Prostate Cancer. Theranostics 2:318–330PubMedCentralPubMedCrossRef

10.

Poulsen MH, Bouchelouche K, Høilund-Carlsen PF et al (2012) [18F]fluoromethylcholine (FCH) positron emission tomography/computed tomography (PET/CT) for lymph node staging of prostate cancer: a prospective study of 210 patients. BJU Int 110:1666–1671PubMedCrossRef

11.

Schiavina R, Scattoni V, Castellucci P et al (2008) 11C-choline positron emission tomography/computerized tomography for preoperative lymph-node staging in intermediate-risk and high-risk prostate cancer: comparison with clinical staging nomograms. Eur Urol 54:392–401PubMedCrossRef

12.

Beheshti M, Imamovic L, Broinger G et al (2010) 18F choline PET/CT in the preoperative staging of prostate cancer in patients with intermediate or high risk of extracapsular disease: a prospective study of 130 patients. Radiology 254:925–933PubMedCrossRef

13.

Heck MM, Retz M, Bandur M, et al. (2013) Topography of lymph node metastases in prostate cancer patients undergoing radical prostatectomy and extended lymphadenectomy: results of a combined molecular and histopathologic mapping study. Eur Urol

14.

Heesakkers RAM, Hövels AM, Jager GJ et al (2008) MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients with prostate cancer: a prospective multicohort study. Lancet Oncol 9:850–856PubMedCrossRef

15.

Hövels AM, Heesakkers RAM, Adang EM et al (2008) The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol 63:387–395PubMedCrossRef

16.

Barentsz JO, Jager G, Mugler JP 3rd et al (1995) Staging urinary bladder cancer: value of T1-weighted three-dimensional magnetization prepared-rapid gradient-echo and two-dimensional spin-echo sequences. AJR Am J Roentgenol 164:109–115PubMedCrossRef

17.

Fütterer JJ, Engelbrecht MR, Jager GJ et al (2007) Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal-pelvic phased-array coils. Local staging accuracy of prostate cancer using endorectal coil MR imaging. Eur Radiol 17:1055–1065PubMedCrossRef

18.

Le Bihan D, Breton E, Lallemand D et al (1986) MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 161:401–407PubMed

19.

Ackerstaff E, Pflug BR, Nelson JB, Bhujwalla ZM (2001) Detection of increased choline compounds with proton nuclear magnetic resonance spectroscopy subsequent to malignant transformation of human prostatic epithelial cells. Cancer Res 61:3599–3603PubMed

20.

Wyss MT, Weber B, Honer M et al (2004) 18F-choline in experimental soft tissue infection assessed with autoradiography and high-resolution PET. Eur J Nucl Med Mol Imaging 31:312–316PubMedCrossRef

21.

Kwee TC, Takahara T, Luijten PR, Nievelstein RAJ (2010) ADC measurements of lymph nodes: inter- and intra-observer reproducibility study and an overview of the literature. Eur J Radiol 75:215–220PubMedCrossRef

Titel: Preoperative lymph node staging in patients with primary prostate cancer: comparison and correlation of quantitative imaging parameters in diffusion-weighted imaging and 11C-choline PET/CT
Publikationsdatum: 01.08.2014
Erschienen in: European Radiology / Ausgabe 8/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3240-8

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Preoperative lymph node staging in patients with primary prostate cancer: comparison and correlation of quantitative imaging parameters in diffusion-weighted imaging and 11C-choline PET/CT

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Purpose

Material and methods

Results

Conclusion

Key Points

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