In vivo uptake of [11C]choline does not correlate with cell proliferation in human prostate cancer

Breeuwsma, A.J.; Pruim, Jan; Jongen, Maud M G J; Suurmeijer, Albert; Vaalburg, W; Nijman, Rien J.M.; Jong, Igle J. de

doi:10.1007/s00259-004-1741-4

Cited by 104 publications

(56 citation statements)

References 27 publications

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“…Similar to previous studies, no significant differences were observed when the SUV was related to PSA or to Gleason score (16,18,26,28), whereas other groups reported of significant correlation between SUV and PSA level (24,25). One of the potential utilities of [ 11 C]choline PET/CT in primary PCa could be to identify patients with more aggressive lesions to avoid sampling error and appropriately direct therapy for higher grade, riskier tumors.…”

Section: Discussionsupporting

confidence: 82%

The Sensitivity of [11C]Choline PET/CT to Localize Prostate Cancer Depends on the Tumor Configuration

Souvatzoglou

Weirich

Schwarzenboeck

et al. 2011

Clinical Cancer Research

100

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Purpose: To evaluate the dependency of the sensitivity of [11 C]choline positron emission tomography/ computed tomography (PET/CT) for detecting and localizing primary prostate cancer (PCa) on tumor configuration in the histologic specimen. Experimental Design: Forty-three patients with biopsy-proven PCa were included. They underwent radical prostatectomy within 31 days after [11 C]choline PET/CT. The transaxial image slices and the histologic specimens were analyzed by comparing the respective slices. Maximum standardized uptake values (SUV max ) were calculated in each segment and correlated with histopathology. The tumor configuration in the histologic specimen was grouped as: I, unifocal; II, multifocal; III, rind-like shaped; IV, size <5 mm. Data analysis included the investigation of detection of PCa by SUV max , the assessment of the influence of potential contributing factors on tumor prediction, and the evaluation of whether SUV could discriminate cancer tissue from benign prostate hyperplasia (BPH), prostatitis, HGPIN (high-grade prostate intraepithelial neoplasm), or normal prostate tissue. General estimation equation models were used for statistical analysis.Results: Tumor configuration in histology was classified as I in 21 patients, as II in 9, as III in 5, and as IV in 8. The prostate segment involved by cancer is identified in 79% of the patients. SUV max was located in the same side of the prostate in 95% of patients. Tumor configuration was the only factor significantly negatively influencing tumor prediction (P < 0.001). PCa-SUV max (median SUV max ¼ 4.9) was not significantly different from BPH-SUV (median SUV max ¼ 4.5) and prostatitis-SUV (median SUV max ¼ 3.9), P ¼ 0.102 and P ¼ 0.054, respectively.Conclusions: The detection and localization of PCa in the prostate with [ 11 C]choline PET/CT is impaired by tumor configuration. Additionally, in our patient population, PCa tissue could not be distinguished from benign pathologies in the prostate.

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Section: Discussionsupporting

confidence: 82%

The Sensitivity of [11C]Choline PET/CT to Localize Prostate Cancer Depends on the Tumor Configuration

Souvatzoglou

Weirich

Schwarzenboeck

et al. 2011

Clinical Cancer Research

100

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“…No hitherto published prospective study of FEC-PET has suggested an association between PET parameters and the Gleason score. Initial [ 11 C]-choline-PET/CT studies with acquisition times starting from 5 to 10 minutes after injection, reported no such significant correlation (33,34). But supporting the present findings, a recently published study using […”

Section: Discussionmentioning

confidence: 99%

Combined PET/MRI Improves Diagnostic Accuracy in Patients with Prostate Cancer: A Prospective Diagnostic Trial

Hartenbach

Bechtloff

et al. 2014

Clinical Cancer Research

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Purpose: The pretherapeutic assessment of prostate cancer is challenging and still holds the risk of overor undertreatment. This prospective trial investigates positron emission tomography (PET) with [ 18 F]fluoroethylcholine (FEC) combined with endorectal magnetic resonance imaging (MRI) for the assessment of primary prostate cancer.Experimental design: Patients with prostate cancer based on needle biopsy findings, scheduled for radical prostatectomy, were assessed by FEC-PET and MRI in identical positioning. After prostatectomy, imaging results were compared with histologic whole-mount sections, and the PET/MRI lesion-based semiquantitative FEC uptake was compared with biopsy Gleason scores and postoperative histology.Results: PET/MRI showed a patient-based sensitivity of 95% (36/38; 95% confidence interval (CI), 82%-99%). The analysis of 128 prostate lesions demonstrated a sensitivity/specificity/positive predictive value/ negative predictive value/accuracy of 67%/35%/59%/44%/54% (P ¼ 0.8295) for MRI and 85%/45%/68%/ 69%/68% (P ¼ 0.0021) for PET, which increased to 84%/80%/85%/78%/82% (P < 0.0001) by combined FEC-PET/MRI in lesions >5 mm (n ¼ 98). For lesions in patients with Gleason >6 tumors (n ¼ 43), MRI and PET achieved 73%/31%/71%/33%/60% (P ¼ 1.0000) and 90%/62%/84%/73%/81% (P ¼ 0.0010), which were improved to 87%/92%/96%/75%/88% (P < 0.0001) by combined PET/MRI. Applying semiquantitative PET analysis, carcinomas with Gleason scores >6 were distinguished from those with Gleason 6 with a specificity of 90% and a positive predictive value of 83% (P ¼ 0.0011; needle biopsy 71%/60%, P ¼ 0.1071).Conclusions: In a prospective diagnostic trial setting, combined FEC-PET/MRI achieved very high sensitivity in the detection of the dominant malignant lesion of the prostate, and markedly improved upon PET or MRI alone. Noninvasive Gleason score assessment was more precise than needle biopsy in this patient cohort. Hence, FEC-PET/MRI merits further investigation in trials of randomized, multiarm design.

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“…49 Vários mecanismos foram postulados como causadores da diminuição do SUV max após TSH: 1) redução do volume da lesão (com redução do sinal por efeito de volume parcial); 2) diminuição dos níveis de proliferação celular e, 3) sub regulação da expressão dos genes que regulam o metabolismo lípídico, incluindo menor actividade do transportador de colina ou da enzima colina quinase. [50][51][52][53][54][55] Contudo, em doentes resistentes à castração, a TSH parece não apresentar os mesmos efeitos.…”

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PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica

et al. 2016

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Results:The overall sensitivity was 63.2% and 80.0% when PSA > 2 ng/mL. It was possible to identify distant disease in 28% of the patients. The sensitivity increased from 40.0%, in patients with low and intermediate risk, to 55.2% in high-risk patients. Without hormonal suppression therapy, the sensitivity was 61.8%, while in the group under this therapy, was 67.7%. Discussion: PET/CT with 18F-Fluorocholine provided important information even in patients with low levels of PSA, however, with significantly increased sensitivity in patients with PSA > 2 ng/mL. Sensitivity was higher in high-risk patients compared with low and intermediate risk patients, however, without a statistically significant difference. The hormone suppression therapy does not appear to influence uptake of 18F-Fluorocholine in patients resistant to castration. Conclusions: In this study, PET/CT with 18F-Fluorocholine showed good results in restaging patients with prostate cancer biochemical recurrence, distinguishing between loco regional and systemic disease, information with important consequences in defining the therapeutic strategy. Keywords: Fluorocholine; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals. INTRODUÇÃOO carcinoma da próstata (CaP) é, na Europa, a neoplasia maligna mais comum no sexo masculino e a segunda causa de morte por cancro, tendo-se assistido a um aumento significativo da sua incidência nas últimas décadas. 1Uma vez que a idade é um factor de risco bem estabelecido no CaP prevê-se que, com o aumento da esperança média de vida, esta doença se torne num problema de saúde pú-blica, cada vez mais relevante. 2Após a terapêutica com intuito curativo, o seguimento destes doentes baseia-se, sobretudo, no doseamento sé-rico do antigénio específico da próstata (PSA) e a recidiva bioquímica é um acontecimento relativamente frequente. Terapêuticas de salvação são reservadas para doentes com recidiva loco regional. Nos doentes com metastização à distância, o tratamento paliativo mais comum é a Terapêutica de Supressão Hormonal (TSH). 4 Contudo, tem-se assistido a uma progressão das terapêuticas disponíveis, com introdução de terapias individualizadas.

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In vivo uptake of [11C]choline does not correlate with cell proliferation in human prostate cancer

Abstract: In vivo uptake of [(11)C]choline does not correlate with cell proliferation in human prostate cancer as depicted by Ki-67. Our results suggest that a process other than proliferation is responsible for the uptake of [(11)C]choline in prostate cancer.

Cited by 104 publications

References 27 publications

The Sensitivity of [11C]Choline PET/CT to Localize Prostate Cancer Depends on the Tumor Configuration

The Sensitivity of [11C]Choline PET/CT to Localize Prostate Cancer Depends on the Tumor Configuration

Combined PET/MRI Improves Diagnostic Accuracy in Patients with Prostate Cancer: A Prospective Diagnostic Trial

PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica

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