2-[ 18F]fluoro-2-deoxyglucose positron emission tomography for the detection of disease in patients with prostate-specific antigen relapse after radical prostatectomy Journal Article
| Authors: | Schoder, H.; Herrmann, K.; Gonen, M.; Hricak, H.; Eberhardt, S.; Scardino, P.; Scher, H. I.; Larson, S. M. |
| Article Title: | 2-[ 18F]fluoro-2-deoxyglucose positron emission tomography for the detection of disease in patients with prostate-specific antigen relapse after radical prostatectomy |
| Abstract: | Experimental Design: Retrospective cohort study in 91 patients with prostate-specific antigen (PSA) relapse following prostatectomy, imaged with 2-[ 18F]fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in a tertiary care cancer center between February 1997 and March 2003. Comparison was made with magnetic resonance imaging (n = 64), bone scan (n = 56), and computed tomography (n = 37). The standard of reference included biopsy or clinical and imaging follow-up. We calculated sensitivity and specificity of PET and correlated PET findings with PSA values, other clinical parameters, and conventional imaging, when available. Results: PET was true positive in 28 of 91 (31%) patients, showing isolated disease in the prostate bed (n = 3) or metastatic disease with (n = 2) or without (n = 23) simultaneous disease in the prostate bed. In detail, PET identified lesions in the prostate bed (n = 5, all true positives), bones (n = 22; 20 true positives, 2 false positives), lymph nodes (n = 7; 6 true positives, 1 likely false positive), and one liver metastasis. Mean PSA was higher in PET-positive than in PET-negative patients (9.5 ± 2.2 versus 2.1 ± 3.3 ng/mL). PSA of 2.4 ng/mL and PSA velocity of 1.3 ng/mL/y provided the best tradeoff between sensitivity (80%; 71%) and specificity (73%; 77%) of PET in a receiver operating curve analysis. Combination with other clinical parameters in a multivariate analysis did not improve disease prediction. There were only two patients in whom other imaging studies showed isolated local recurrence or metastatic disease. Conclusions: FDG-PET detected local or systemic disease in 31% of patients with PSA relapse referred for this test. There is a link to tumor burden and tumor biology in that the probability for disease detection increased with PSA levels. © 2005 American Association for Cancer Research. |
| Keywords: | adult; controlled study; human tissue; aged; bone neoplasms; middle aged; bone tumor; retrospective studies; major clinical study; clinical feature; cancer localization; cancer recurrence; nuclear magnetic resonance imaging; positron emission tomography; follow up; methodology; follow-up studies; lymph node metastasis; lymphatic metastasis; sensitivity and specificity; prostate specific antigen; metastasis; computer assisted tomography; neoplasm recurrence, local; cohort analysis; pathology; retrospective study; prostate cancer; prostate-specific antigen; prostatic neoplasms; imaging system; liver metastasis; blood; correlation coefficient; diagnostic agent; prostatectomy; tumor recurrence; prostate tumor; fluorodeoxyglucose f 18; medronate technetium tc 99m; fluorodeoxyglucose f18; positron-emission tomography; scintiscanning; intermethod comparison; cancer relapse; contrast medium; multivariate analysis; bone scintiscanning; receiver operating characteristic; sensitivity and sensibility |
| Journal Title: | Clinical Cancer Research |
| Volume: | 11 |
| Issue: | 13 |
| ISSN: | 1078-0432 |
| Publisher: | American Association for Cancer Research |
| Date Published: | 2005-07-01 |
| Start Page: | 4761 |
| End Page: | 4769 |
| Language: | English |
| DOI: | 10.1158/1078-0432.ccr-05-0249 |
| PROVIDER: | scopus |
| PUBMED: | 16000572 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 79" - "Export Date: 24 October 2012" - "CODEN: CCREF" - "Source: Scopus" |
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