18F-fluorodeoxyglucose PET/CT for detection of disease in patients with prostate-specific antigen relapse following radical treatment of a local-stage prostate cancer

Abstract

Abstract. The present study aimed to retrospectively review the contribution of 18 F-fluorodeoxygluose-positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in the assessment of biochemical recurrence in patients with a diagnosis of local-stage prostate cancer (PCa) who underwent radical prostatectomy (RP) or received external beam radiation therapy (EBRT). A total of 28 patients who underwent RP or received EBRT for PCa between July 2007 and April 2013, and who underwent 18 F-FDG PET/CT scanning for re-staging due to biochemical recurrence were included in the present study. The mean age of the patients was 65.07 years and the standard deviation was 7.51 years (range, 51-82 years). Of the 28 patients, 23 (82.1%) underwent RP and 5 (17.9%) received definitive EBRT. Prior to scanning, all patients were required to fast for 6 h, and ~1 h after the intravenous injection of 555 MBq 18 F-FDG, whole-body PET scans were performed from the skull base to the upper thighs. Whole-body CT scans were performed in the craniocaudal direction.18 F-FDG PET images were reconstructed using CT data for attenuation correction. Histopathology examination or clinical follow-up was used to confirm any suspicious recurrent or metastatic lesions. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18 F-FDG PET/CT were 61.6, 75.0, 61.6, 75.0 and 71.4%, respectively. 18 F-FDG PET/CT can detect local and distant metastases with a high accuracy in the assessment of biochemical recurrence, thus detecting occult metastases and allowing the re-staging of PCa in the patients receiving definitive treatment. It is considered that 18 F-FDG PET/CT may be useful in re-assessing the patients with PCa receiving definitive treatment.

PET of Glucose Metabolism and Cellular Proliferation in Prostate Cancer

“…The 18 F-FDG PET/CT detection rate was only 8.1% in the setting of biochemical recurrence. In another recent investigation, involving 28 patients with PSA relapse after definitive primary therapy (82.1% radical prostatectomy and 17.9% external-beam radiation therapy), the sensitivity and specificity of 18 F-FDG PET/ CT were 61.6% and 75%, respectively (20). Schöder et al reported a positive detection rate of 31% in this clinical setting (21).…”

Case: Incidental 18F-fluorodeoxyglucose-positron emission tomography/computed tomography prostate uptake: How should these patients be managed?

“…4,14,15 In one study Minamimoto et al concluded that FDG-PET/CT could potentially detect prostate cancer with 80.0% sensitivity and 87.0% positive predictive value in cases with a Gleason score of 7 or greater. 15 Also, the anatomic location of the incidental uptake should be considered.…”

Radiotrazadores empleados en medicina nuclear para el diagnóstico y seguimiento del cáncer de próstata

“…demostraron una sensibilidad del 61.6% y una especificidad del 75%, después del tratamiento definitivo (prostatectomía radical o radioterapia) 48 . En un estudio comparativo de 18F-FDG con 11C-colina se ha encontrado que la combinación de ambos radiotrazadores incrementa la sensibilidad hasta en un 80% y la especificidad hasta en un 40% en pacientes con niveles de PSA > 1.9 ng/ml 49 .…”