[F-18]-fluorodeoxyglucose PET-CT of the normal prostate gland

Abstract

Objective-We determined the glucose metabolism and computed tomographic (CT) density of the normal prostate gland in relation to age and prostate size on [F-18] fluorodeoxyglucose positron emission tomography (PET)-CT.Methods-We determined the CT density (Hounsfield Units, HU) and glucose metabolism (standardized uptake value, SUV) of the normal prostate in 145 men (age range 22-97 years) on PET-CT scans which were performed for indications unrelated to prostate pathology. Correlations among SUV, HU, prostate size, and age were calculated using Pearson's correlation coefficients, scatter plots, and linear regression trend lines. The SUV and HU values were also compared among different primary cancer types using the Kruskal-Wallis test.Results-The population average and range of the normal prostate size were 4.3 ± 0.5 cm (mean ± SD) and 2.9-5.5 cm, respectively. The population average of mean and maximum CT densities was 36.0 ± 5.1 HU (range 23-57) and 91.7 ± 20.1 HU (range 62-211), respectively. The population average of mean and maximum SUV was 1.3 ± 0.4 (range 0.1-2.7) and 1.6 ± 0.4 (range 1.1-3.7), respectively. Mean SUV tended to decrease as the prostate size increased (r = −0.16, P = 0.058). Higher mean HU was correlated with higher mean SUV (r = 0.18, P = 0.033). The strongest association was observed between age and prostate size. The prostate gets larger as age increases (r = 0.32, P < 0.001). Prostate mean SUV, max SUV, mean HU, and max HU were not significantly different among different types of primary cancers.Conclusions-Although the normal prostate size increases with age, it does not significantly affect the gland's metabolism and CT density, and therefore age-correction of these parameters may be unnecessary.

The Effect of Patient Age on Standardized Uptake Value-Hounsfield Unit Values of Male Genitourinery Structures In F-18 FDG PET/CT

“…It seems that the metabolic activity and tissue density of the prostate gland do not significantly change from puberty to middle age. Jadvar et al (5) also reached this conclusion. They concluded their aforementioned study stating that the normal prostate size increases with age, it does not significantly affect metabolism of the gland and CT density.…”

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

“…1,3,4 One reason underlying this poor performance is the relatively low metabolic rate of prostate tissue. [3][4][5][6] Also, the proximity of the bladder and the high urinary excretion of 18F-FDG can lead to diagnostic misinterpretations. Moreover, certain benign conditions may be associated with an incidental 18F-FDG uptake, including benign prostatic hyperplasia, bacillus Calmette-Guerin (BCG)-induced granulomatous prostatitis, acute prostatitis, and cystic malformations.…”

“…Moreover, certain benign conditions may be associated with an incidental 18F-FDG uptake, including benign prostatic hyperplasia, bacillus Calmette-Guerin (BCG)-induced granulomatous prostatitis, acute prostatitis, and cystic malformations. 1,3,5,7 The limited usefulness of 18F-FDG in prostate cancer screening has been a motivating factor in developing other radiotracers for prostate cancer. 3 Nonetheless, the use of 18F-FDG PET/CT is increasing and incidental prostate lesions occur in about 1% (0.6-2.3%) of patients.…”

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

“…Thus, 18 F-FDG PET/CT has a limited role in the primary staging of PCa. Nonetheless, FDG-PET application has not yet been full developed for PCa (24).…”