Title: Is there an additional value of 11C-choline PET-CT to T2-weighted MRI images in the localization of intraprostatic tumor nodules?
Authors: Van den Bergh, Laura ×
Koole, Michel
Isebaert, Sofie
Joniau, Steven
Deroose, Christophe
Oyen, Raymond
Lerut, Evelyne
Budiharto, Tom
Mottaghy, Felix
Bormans, Guy
Van Poppel, Hendrik
Haustermans, Karin #
Issue Date: Aug-2012
Publisher: Pergamon Press
Series Title: International Journal of Radiation Oncology, Biology, Physics vol:83 issue:5 pages:1486-1492
Abstract: Introduction
Randomized dose-escalation studies have demonstrated that
higher doses to the entire prostate result in reduced biochemical
failure rates, but this comes at the cost of normal tissue toxicity
(1e3). It has also been shown that local recurrences usually
initiate at the primary tumor site (4, 5). Whole prostate irradiation
with dose-escalation to intraprostatic lesions only could be
a possible alternative to whole gland dose-escalation, with only
minor changes in doses to organs at risk (6). Therefore, accurate
localization of intraprostatic tumor nodules is indispensable.
Although T2-weighted (T2w) MRI has excellent soft tissue
resolution, allowing lesion detection and local staging, wide
ranges of sensitivity and specificity of respectively 27%e100%
and 32%e99% have been reported (7). Moreover, it is known that
in contrast with peripheral zone carcinomas, cancers in the transition
zone are even more challenging to detect because the signal
characteristics of the normal and hypertrophic central gland are
usually similar to those of the tumor.
In recent years, several functional imaging techniques have
offered an alternative approach for detecting tumors trying to reflect
biological tumor characteristics instead of morphological changes.
Next to various functionalMRItechniques such as dynamic contrastenhanced
MRI, diffusion-weighted MRI, and MR spectroscopy,
Hara et al. (8) were the first to demonstrate that prostate cancer (PCa)
and its local metastases could be clearly visualized with PET using
11carbon(C)-choline. Choline is an important component of phospholipids
in the cell membrane. Because of the increased choline
metabolism in proliferative malignant tissue relative to normal
tissue, radiolabeled choline PET scans have the potential to depict
PCa sites (8e11). However, no clear agreement exists on the
diagnostic performance of 11C-choline PET-CT in PCa, because
several groups reported a significant overlap in uptake values
between malignant and benign hyperplastic prostatic tissue (12).
The aim of this study was to investigate the additional value of
11C-choline PET-CT opposed to T2w MRI in localizing intraprostatic
tumor nodules, using histopathology as the gold standard.
Furthermore, we compared 11C-choline PET standardized
uptake values (SUVs) for malignant and benign prostate tissue and
investigated the possible correlation between tracer uptake and
T-stage of the tumor, Gleason score, prostate-specific antigen
(PSA), and tumor volume.
ISSN: 0360-3016
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Experimental Radiotherapy
Nuclear Medicine & Molecular Imaging
Screening, Diagnostics and Biomarkers (-)
Translational Cell & Tissue Research
Radiopharmaceutical Research
× corresponding author
# (joint) last author

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