Virchow Node From Prostate Carcinoma by 18F-Choline PET/CT

Riva-Pérez, Pablo Antonio de la; García-Gómez, Francisco Javier; Buján-Lloret, Cristina; Calvo-Morón, María de la Cinta; Castro-Montaño, Juan

doi:10.1097/rlu.0000000000001975

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…One previous study also reported that 3.2% of the treatmentnaïve patients have LNMs in the Virchow nodes (8). The study showed that the Virchow nodes were significantly more frequent with a GS ≥8 as compared to a GS ≤7b primary PC tumor (8,42).…”

Section: Discussionmentioning

confidence: 79%

The Establishment of New Thresholds for PLND-Validated Clinical Nomograms to Predict Non-Regional Lymph Node Metastases: Using 68Ga-PSMA PET/CT as References

et al. 2021

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PurposePLND (pelvic lymph node dissection)-validated nomograms are widely accepted clinical tools to determine the necessity of PLND by predicting the metastasis of lymph nodes (LNMs) in pelvic region. However, these nomograms are in lacking of a threshold to predict the metastasis of extrareolar lymph nodes beyond pelvic region, which is not suitable for PLND. The aim of this study is to evaluate a threshold can be set for current clinical PLND-validated nomograms to predict extrareolar LN metastases beyond pelvic region in high-risk prostate cancer patients, by using 68Ga-PSMA PET/CT as a reference to determine LN metastases (LNMs).Experimental DesignWe performed a retrospective analysis of 57 high-risk treatment-naïve PC patients in a large tertiary care hospital in China who underwent 68Ga-PSMA-617 PET/CT imaging. LNMs was detected by 68Ga-PSMA-617 PET/CT and further determined by imaging follow-up after anti-androgen therapy. The pattern of LN metastatic spread of PC patients were evaluated and analyzed. The impact of 68Ga-PSMA PET/CT on clinical decisions based on three clinical PLND-validated nomograms (Briganti, Memorial Sloan Kettering Cancer Center, Winter) were evaluated by a multidisciplinary prostate cancer therapy team. The diagnostic performance and the threshold of these nomograms in predicting extrareolar LNMs metastasis were evaluated via receiver operating characteristic (ROC) curve analysis.ResultsLNMs were observed in 49.1% of the patients by 68Ga-PSMA PET/CT, among which 65.5% of LNMs were pelvic-regional and 34.5% of LNMs were observed in extrareolar sites (52.1% of these were located above the diaphragm). The Briganti, MSKCC and Winter nomograms showed that 70.2%-71.9% of the patients in this study need to receive ePLND according to the EAU and NCCN guidelines. The LN staging information obtained from 68Ga-PSMA PET/CT would have led to changes of planned management in 70.2% of these patients, including therapy modality changes in 21.1% of the patients, which were mainly due to newly detected non-regional LNMs. The thresholds of nomograms to predict non-regional LNMs were between 64% and 75%. The PC patients with a score >64% in Briganti nomogram, a score >75% in MSKCC nomogram and a score >67% in Winter nomogram were more likely to have non-regional LNMs. The AUCs (Area under curves) of the clinical nomograms (Briganti, MSKCC and Winter) in predicting non-regional LNMs were 0.816, 0.830 and 0.793, respectively.ConclusionsBy using 68Ga-PSMA PET/CT as reference of LNM, the PLND-validated clinical nomograms can not only predict regional LNMs, but also predict non-regional LNMs. The additional information from 68Ga-PSMA PET/CT may provide added benefit to nomograms-based clinical decision-making in more than two-thirds of patients for reducing unnecessary PLND. We focused on that a threshold can be set for current clinical PLND-validated nomograms to predict extrareolar LN metastases with an AUC accuracy of about 80% after optimizing the simple nomograms which may help to improve the efficiency for PC therapy significantly in clinical practice.

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Section: Discussionmentioning

confidence: 79%

The Establishment of New Thresholds for PLND-Validated Clinical Nomograms to Predict Non-Regional Lymph Node Metastases: Using 68Ga-PSMA PET/CT as References

et al. 2021

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“…In recent decades, multiple reports have been published wherein the latest imaging modalities have uncovered VTN otherwise not clearly revealed on physical examination [24][25][26] Cham et al [25] reported a 56-year-old man with a recent diagnosis of distal esophageal carcinoma, in whom whole-body F-18 FDG scintigraphy was performed for staging. The scintigraphy had shown a large primary carcinoma of the mid-to-distal esophagus above the level of the gastroesophageal junction, two normal-size right retrocrural nodes, and left supraclavicular adenopathy (VTN).…”

Section: Virchow-troisier's Node and Latest Imaging Modalitiesmentioning

confidence: 99%

“…The scintigraphy had shown a large primary carcinoma of the mid-to-distal esophagus above the level of the gastroesophageal junction, two normal-size right retrocrural nodes, and left supraclavicular adenopathy (VTN). de la Riva-Pérez et al [26] reported a 75-yearold man with unsuspected involvement of VTN from prostate cancer observed using F-choline PET/CT. El Salvador Atlas of Gastrointestinal Video Endoscopy (https://www.gastrointestinalatlas.…”

Section: Virchow-troisier's Node and Latest Imaging Modalitiesmentioning

confidence: 99%

Virchow-Troisier's Node: A Review

Salati

Alsuwaydani

2023

J. Anal. Oncol.

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Virchow-Troisier's node is an eponymous term referring to the enlargement of the left supraclavicular lymph node. It is a significant physical finding that generally indicates the late manifestation of a variety of malignancies. This review article briefly revisits the historical background, epidemiology, anatomical routes of metastasis, clinical presentation, differential diagnosis, and clinical significance of Virchow-Troisier's node.

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18F-DCFPyL PET/CT in Oncocytoma

Li¹,

Xu²,

Kim

et al. 2018

Clin Nucl Med

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A 76-year-old man with biochemical failure after primary radiotherapy for prostate cancer had no malignant disease detected on 99mTc-MDP bone scan and diagnostic CT. Prostate-specific membrane antigen (PSMA), a type II transmembrane glycoprotein, is overexpressed in prostate cancer cells. The PSMA-targeted 18F-DCFPyL PET/CT demonstrated lymph node disease and photopenic defects in the left kidney associated with a cyst and biopsy-proven oncocytoma. Prostate-specific membrane antigen is expressed in the neovasculature of several solid tumors. It has been reported that PSMA expression is seen in approximately 50% of oncocytoma versus 76% of clear cell renal carcinomas. Biopsy confirmation is needed regardless of 18F-DCFPyL avidity.

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Virchow Node From Prostate Carcinoma by 18F-Choline PET/CT

Cited by 4 publications

References 6 publications

The Establishment of New Thresholds for PLND-Validated Clinical Nomograms to Predict Non-Regional Lymph Node Metastases: Using 68Ga-PSMA PET/CT as References

The Establishment of New Thresholds for PLND-Validated Clinical Nomograms to Predict Non-Regional Lymph Node Metastases: Using 68Ga-PSMA PET/CT as References

Virchow-Troisier's Node: A Review

18F-DCFPyL PET/CT in Oncocytoma

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