18F‐Fluorocholine PET/CT in prostate cancer initial staging
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24915/aup.33.3.34 |
Resumo: | AimIn the evaluation of prostate cancer, clinical nomograms are commonly used to predict the probability of lymphatic and extra‐nodal spread. Those nomograms may suggest the presence and the extension of this cancer but do not allow a clear distinction between loco‐regional and distant disease. In this study, it was intended to evaluate the usefulness of 18F‐Fluorocoline positron emission tomography/computed tomography (18F‐FCH‐PET/CT) in the workup of patients with the initial diagnosis of prostate cancer and staged by this imaging technique.Material and methodsThe medical records of 39 patients with prostate cancer who underwent 18F‐FCH PET/CT for initial staging, between November 2010 and April 2015, were reviewed. Of these, 20 patients were excluded because they had already started hormonotherapy. In the other 19 patients, the performance of 18F‐FCH PET/CT for the detection of lymph node metastasis was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Six patients had performed pelvic lymphadenectomy (total of 69 lymph nodes), allowing histological confirmation. When there was no histological confirmation (total of 30 lymph nodes and 3 cases of bone metastasis), the findings of 18F‐FCH PET/CT were correlated with the values of PSA and the information from multiple imaging modalities such as CT, bone scan, magnetic resonance (MRI), 18F‐Sodium Fluoride (18F‐NaF) PET/CT of control.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for lymph node metastasis detection were, respectively, 96.8%, 80.9%, 69.8%, 98.2% and 85.8%. In our sample, this technique also allowed the identification of nodal extra pelvic or bone metastasis in 5 patients (26.3%) with implications in the treatment. It showed uptake suggestive of bone metastasis, corroborated by other diagnostic technics or by the follow‐up, in 3 patients, those with prostate specific antigen (PSA) of 9.5±2.9 ng/mL.Conclusion18F‐FCH PET/CT is an entire body and multi organ imaging modality that allows the identification, globally, of the sites of disease in patients with prostate cancer. In this study, 18F‐FCH PET/CT showed good results when used in the initial staging of these patients. It is highlighted the ability to detect distant disease, in particular bone metastasis, even with PSA<20ng/mL. |
id |
RCAP_7aea83b50e51718f86826cbf86c64321 |
---|---|
oai_identifier_str |
oai:oai.actaurologicaportuguesa.com:article/34 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
18F‐Fluorocholine PET/CT in prostate cancer initial stagingPET/CT com Fluorocolina‐F18 no estadiamento inicial do carcinoma da próstataFluorocholineProstatic NeoplasmsRadiopharmaceuticalsPositron‐Emission TomographyFluorocolinaNeoplasias da próstataRadiofármacosTomografia por emissão de positrõesAimIn the evaluation of prostate cancer, clinical nomograms are commonly used to predict the probability of lymphatic and extra‐nodal spread. Those nomograms may suggest the presence and the extension of this cancer but do not allow a clear distinction between loco‐regional and distant disease. In this study, it was intended to evaluate the usefulness of 18F‐Fluorocoline positron emission tomography/computed tomography (18F‐FCH‐PET/CT) in the workup of patients with the initial diagnosis of prostate cancer and staged by this imaging technique.Material and methodsThe medical records of 39 patients with prostate cancer who underwent 18F‐FCH PET/CT for initial staging, between November 2010 and April 2015, were reviewed. Of these, 20 patients were excluded because they had already started hormonotherapy. In the other 19 patients, the performance of 18F‐FCH PET/CT for the detection of lymph node metastasis was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Six patients had performed pelvic lymphadenectomy (total of 69 lymph nodes), allowing histological confirmation. When there was no histological confirmation (total of 30 lymph nodes and 3 cases of bone metastasis), the findings of 18F‐FCH PET/CT were correlated with the values of PSA and the information from multiple imaging modalities such as CT, bone scan, magnetic resonance (MRI), 18F‐Sodium Fluoride (18F‐NaF) PET/CT of control.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for lymph node metastasis detection were, respectively, 96.8%, 80.9%, 69.8%, 98.2% and 85.8%. In our sample, this technique also allowed the identification of nodal extra pelvic or bone metastasis in 5 patients (26.3%) with implications in the treatment. It showed uptake suggestive of bone metastasis, corroborated by other diagnostic technics or by the follow‐up, in 3 patients, those with prostate specific antigen (PSA) of 9.5±2.9 ng/mL.Conclusion18F‐FCH PET/CT is an entire body and multi organ imaging modality that allows the identification, globally, of the sites of disease in patients with prostate cancer. In this study, 18F‐FCH PET/CT showed good results when used in the initial staging of these patients. It is highlighted the ability to detect distant disease, in particular bone metastasis, even with PSA<20ng/mL.ObjetivoNa avaliação do carcinoma da próstata são habitualmente utilizados nomogramas clínicos para prever a probabilidade de disseminação linfática e extra ganglionar. Esses nomogramas podem sugerir a presença e a extensão desta neoplasia, mas não permitem a distinção clara entre doença loco regional e à distância. Pretendeu‐se, com este trabalho, avaliar a utilidade da tomografia por emissão de positrões/tomografia computorizada (PET/CT) com Fluorocolina‐F18 (FCH‐F18) na orientação de doentes com o diagnóstico inicial de carcinoma da próstata e estadiados por esta técnica imagiológica.Material e métodosForam revistos os processos clínicos de 39 doentes com carcinoma da próstata que realizaram PET/CT com FCH‐F18 para estadiamento inicial, entre novembro de 2010 e abril de 2015. Destes, 20 doentes foram excluídos por terem iniciado hormonoterapia. Nos restantes 19 doentes, foi avaliado o desempenho da PET/CT com FCH‐F18 para deteção de metastização ganglionar através do cálculo dos valores de sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acuidade diagnóstica. Seis doentes realizaram linfadenectomia pélvica (total de 69 gânglios), permitindo confirmação histológica. Quando não existia confirmação histológica, os achados da PET/CT com FCH‐F18 (total de 30 gânglios e 3 casos de metastização óssea) foram correlacionados com os valores do antigénio prostático específico (PSA) e com as informações de várias modalidades imagiológicas, como CT, cintigrafia óssea, ressonância magnética (RM), PET/CT com Fluoreto de Sódio‐F18 (FNa‐F18) e PET/CT com FCH‐F18 de controlo.ResultadosOs valores de sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acuidade diagnóstica para deteção de metastização ganglionar foram, respetivamente, 96,8%, 80,9%, 69,8%, 98,2% e 85,8%. Na nossa amostra, esta técnica identificou metástases, ganglionares extrapélvicas ou ósseas em 5 doentes (26,3%) com implicações na abordagem terapêutica. Mostrou captação sugestiva de metastização óssea, corroborada por outros meios de diagnóstico e pelo seguimento, em 3 doentes, estes com PSA de 9,5±2,9ng/mL.ConclusõesA PET/CT com FCH‐F18 é uma modalidade imagiológica de corpo inteiro e multiorgão que permite identificar, de modo global, os locais de doença, em doentes com carcinoma da próstata. Neste estudo, a PET/CT com FCH‐F18 apresentou bons resultados quando utilizada no processo de estadiamento inicial destes doentes. Salienta‐se a sua capacidade para deteção de doença à distância, nomeadamente óssea, mesmo com PSA<20ng/mL.Associação Portuguesa de Urologia2017-04-10T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24915/aup.33.3.34oai:oai.actaurologicaportuguesa.com:article/34Acta Urológica Portuguesa; Vol. 33 No. 3 (2016): Setembro-Dezembro; 87-97Acta Urológica Portuguesa; v. 33 n. 3 (2016): Setembro-Dezembro; 87-972387-04192341-4022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://www.actaurologicaportuguesa.com/index.php/aup/article/view/34https://doi.org/10.24915/aup.33.3.34http://www.actaurologicaportuguesa.com/index.php/aup/article/view/34/4Lapa, PaulaSilva, RodolfoSaraiva, TiagoFigueiredo, ArnaldoFerreira, RuiCosta, GracindaPedroso Lima, Joãoinfo:eu-repo/semantics/openAccess2022-09-21T09:04:45Zoai:oai.actaurologicaportuguesa.com:article/34Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:55:52.507006Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
18F‐Fluorocholine PET/CT in prostate cancer initial staging PET/CT com Fluorocolina‐F18 no estadiamento inicial do carcinoma da próstata |
title |
18F‐Fluorocholine PET/CT in prostate cancer initial staging |
spellingShingle |
18F‐Fluorocholine PET/CT in prostate cancer initial staging Lapa, Paula Fluorocholine Prostatic Neoplasms Radiopharmaceuticals Positron‐Emission Tomography Fluorocolina Neoplasias da próstata Radiofármacos Tomografia por emissão de positrões |
title_short |
18F‐Fluorocholine PET/CT in prostate cancer initial staging |
title_full |
18F‐Fluorocholine PET/CT in prostate cancer initial staging |
title_fullStr |
18F‐Fluorocholine PET/CT in prostate cancer initial staging |
title_full_unstemmed |
18F‐Fluorocholine PET/CT in prostate cancer initial staging |
title_sort |
18F‐Fluorocholine PET/CT in prostate cancer initial staging |
author |
Lapa, Paula |
author_facet |
Lapa, Paula Silva, Rodolfo Saraiva, Tiago Figueiredo, Arnaldo Ferreira, Rui Costa, Gracinda Pedroso Lima, João |
author_role |
author |
author2 |
Silva, Rodolfo Saraiva, Tiago Figueiredo, Arnaldo Ferreira, Rui Costa, Gracinda Pedroso Lima, João |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Lapa, Paula Silva, Rodolfo Saraiva, Tiago Figueiredo, Arnaldo Ferreira, Rui Costa, Gracinda Pedroso Lima, João |
dc.subject.por.fl_str_mv |
Fluorocholine Prostatic Neoplasms Radiopharmaceuticals Positron‐Emission Tomography Fluorocolina Neoplasias da próstata Radiofármacos Tomografia por emissão de positrões |
topic |
Fluorocholine Prostatic Neoplasms Radiopharmaceuticals Positron‐Emission Tomography Fluorocolina Neoplasias da próstata Radiofármacos Tomografia por emissão de positrões |
description |
AimIn the evaluation of prostate cancer, clinical nomograms are commonly used to predict the probability of lymphatic and extra‐nodal spread. Those nomograms may suggest the presence and the extension of this cancer but do not allow a clear distinction between loco‐regional and distant disease. In this study, it was intended to evaluate the usefulness of 18F‐Fluorocoline positron emission tomography/computed tomography (18F‐FCH‐PET/CT) in the workup of patients with the initial diagnosis of prostate cancer and staged by this imaging technique.Material and methodsThe medical records of 39 patients with prostate cancer who underwent 18F‐FCH PET/CT for initial staging, between November 2010 and April 2015, were reviewed. Of these, 20 patients were excluded because they had already started hormonotherapy. In the other 19 patients, the performance of 18F‐FCH PET/CT for the detection of lymph node metastasis was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Six patients had performed pelvic lymphadenectomy (total of 69 lymph nodes), allowing histological confirmation. When there was no histological confirmation (total of 30 lymph nodes and 3 cases of bone metastasis), the findings of 18F‐FCH PET/CT were correlated with the values of PSA and the information from multiple imaging modalities such as CT, bone scan, magnetic resonance (MRI), 18F‐Sodium Fluoride (18F‐NaF) PET/CT of control.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for lymph node metastasis detection were, respectively, 96.8%, 80.9%, 69.8%, 98.2% and 85.8%. In our sample, this technique also allowed the identification of nodal extra pelvic or bone metastasis in 5 patients (26.3%) with implications in the treatment. It showed uptake suggestive of bone metastasis, corroborated by other diagnostic technics or by the follow‐up, in 3 patients, those with prostate specific antigen (PSA) of 9.5±2.9 ng/mL.Conclusion18F‐FCH PET/CT is an entire body and multi organ imaging modality that allows the identification, globally, of the sites of disease in patients with prostate cancer. In this study, 18F‐FCH PET/CT showed good results when used in the initial staging of these patients. It is highlighted the ability to detect distant disease, in particular bone metastasis, even with PSA<20ng/mL. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-04-10T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24915/aup.33.3.34 oai:oai.actaurologicaportuguesa.com:article/34 |
url |
https://doi.org/10.24915/aup.33.3.34 |
identifier_str_mv |
oai:oai.actaurologicaportuguesa.com:article/34 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://www.actaurologicaportuguesa.com/index.php/aup/article/view/34 https://doi.org/10.24915/aup.33.3.34 http://www.actaurologicaportuguesa.com/index.php/aup/article/view/34/4 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Associação Portuguesa de Urologia |
publisher.none.fl_str_mv |
Associação Portuguesa de Urologia |
dc.source.none.fl_str_mv |
Acta Urológica Portuguesa; Vol. 33 No. 3 (2016): Setembro-Dezembro; 87-97 Acta Urológica Portuguesa; v. 33 n. 3 (2016): Setembro-Dezembro; 87-97 2387-0419 2341-4022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799130427642871808 |