scholarly journals Current evaluation of the clinical utility of Fluoromethylcholine-(18F) PET/CT in Prostate Cancer

2008 ◽  
Vol 51 (spe) ◽  
pp. 71-75
Author(s):  
Jean-Nöel Talbot ◽  
Yanna-Marina Chevalme
Keyword(s):  
Prostate Cancer ◽  
False Negative ◽  
Distant Metastases ◽  
Short Review ◽  
Current Status ◽  
Current Evidence ◽  
Cancer Tissue ◽  
Negative Results ◽  
Pet Ct ◽  
Pet Radiopharmaceutical

This short review is dedicated to the current status of the assessment of a new PET radiopharmaceutical, fluoromethylcholine-(18F) or FCH, which is taken-up by prostate cancer tissue, in contrary to fluorodeoxyglucose-(18F) or FDG. It seems that FCH could become "the FDG of prostate cancer", with the same type of achievements (detection of distant metastases and of occult recurrences, restaging prior to invasive treatments), and the same drawbacks (false negative results in case of small lesions, in particular lymph nodes metastases, and false positive results in case of infection/inflammation, in particular prostatitis). Current evidence is summarised and discussed for each of the potential settings of FCH PET/CT imaging in prostate cancer. The perspectives for granting a marketing authorisation to a FCH preparation are briefly analysed.

scholarly journals Current status and new approaches in prostate cancer diagnosis

2018 ◽  
Vol 128 (4) ◽  
pp. 166-169
Author(s):  
Maria Pyda-Karwicka ◽  
Malwina Karwicka ◽  
Janusz Kopczyński ◽  
Magdalena Orłowska ◽  
Mariusz Krata ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Progression ◽  
Cancer Diagnosis ◽  
False Negative ◽  
Specific Antigen ◽  
Elevated Serum ◽  
Diagnostic Methods ◽  
Current Status ◽  
Cancer Tissue ◽  
Prostate Cancer Diagnosis

Abstract Prostate adenocarcinoma, remaining among top most common cancers, is a heterogeneous group of tumors with a diverse morphological structure. Basing on the histological architecture of cancer tissue, individual cases can be classified into different therapeutic groups. Current diagnosis of prostate cancer brings many challenges. The major problem is the lack of effective and accessible diagnostic methods that would eliminate incidences of overdiagnosis and prevent unnecessary treatments of many patients. There are many efforts to determine favorable and unfavorable molecular prognostic factors. The basic marker currently used in this field is prostate-specific antigen (PSA). Increased level of PSA may suggest the presence of prostate cancer although its level is not specific for the disease and can be elevated also in certain benign hyperplastic or inflammatory conditions as well as after irritation or rectal examination. Clinical symptoms such as dysuria or hematuria are often uncharacteristic and benign prostatic diseases which cannot be confirmed on the basis of physical examination alone. Also, we often deal with the situation of false negative results of prostate needle biopsy, which require many tests to determine the final correct diagnosis. Moreover, prostate cancer can also be present in patients with non-elevated serum PSA level. Due to such difficulties, the search for new molecular markers that could be used for diagnostic purposes is underway. Evaluation of survivin level in prostate cancer tissue may serve as a new diagnostic indicator of prostate cancer progression. Other useful molecular biomarkers with good potential in prostate cancer diagnosis are AMACR (Alpha Methyl Acyl Coenzyme A Racemase), p-63 or Ki-67 or microRNAs present in body fluids.

PET/CT WITH 68GA-PSMA-11 IN DETECTION OF PRIMARY TUMOR AND RECURRENCE OF PROSTATE CANCER

2018 ◽  
Vol 64 (6) ◽  
pp. 799-804
Author(s):  
Darya Ryzhkova ◽  
M. Poyda
Keyword(s):  
Prostate Cancer ◽  
Primary Tumor ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Negative Results ◽  
Primary Prostate Cancer ◽  
Pet Ct ◽  
The Relationship ◽  
Positive Results ◽  
T Category

Purpose: To study the diagnostic value of PET-CT with 68Ga-PSMA-11 in the diagnosis of a primary prostate cancer, preoperative staging, and the detection of recurrence of prostate cancer (PCa). Methods: 28 patients aged 64.7 ± 8.74 years were included. 10 patients primary prostate cancer, and 18 patients with biochemical recurrence of the disease after radical treatment were examined. All patients underwent PET-CT with 68Ga-PSMA-11 according the whole body protocol. Interpretation of images was performed visually and quantitatively by calculation of SUL max. Results: High focal or diffuse 68Ga-PSMA-11 uptake was found in prostate parenchyma in patients with primary prostate cancer. Additionally metastases in regional lymph nodes were diagnosed in 4 patients and bone metastases were found in one patient. The correlation between 68Ga-PSMA-11 uptake level and Gleason index in the primary tumor (R Spearmen = 0.25, p = 0.57) was not observed. PET-positive results were obtained in 14 patients and PET-negative results in 4 patients with biochemical recurrence of PCa. The relationship between the frequency of PET-positive results and Gleason index was not revealed (R Spearmen = 0.2, p = 0.39). We found a weak but significant correlation between the frequency of PET-positive results and the prostate tumor stage according to the T category (R Spearmen = 0.49, p = 0.049). In patients with low values of PSA (less than 1.0 ng/ml) in 4 out of 9 cases, PET-negative results were obtained. In patients with PSA level more than 1.0 ng/ml PET-positive results were obtained in all cases. Conclusions: PET/CT with 68Ga-PSMA-11 allows to diagnose the primary prostate cancer, to establish the stage of the disease in categories N and M, and also to determine the localization and dissemination of the tumor in patients with biochemical recurrence of prostate cancer. The relationship between 68Ga-PSMA-11 uptake in primary tumor and Gleason index was not found. The probability of obtaining PET-positive results in cases of biochemical recurrence is affected by a PSA level above 1 ng/ml and a high stage of the disease according to the T category (T3-T4).

scholarly journals 18F-Fluciclovine Positron Emission Tomography in Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 304
Author(s):  
Giuseppina Biscontini ◽  
Cinzia Romagnolo ◽  
Chiara Cottignoli ◽  
Andrea Palucci ◽  
Fabio Massimo Fringuelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Meta Analysis ◽  
False Negative ◽  
Final Analysis ◽  
Emission Tomography ◽  
True Negative ◽  
Positron Emission ◽  
Pet Ct

Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting. Methods: A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were “PET” or “positron emission tomography” or “positron emission tomography/computed tomography” or “PET/CT” or “positron emission tomography-computed tomography” or “PET-CT” and “Fluciclovine” or “FACBC” and “prostatic neoplasms” or “prostate cancer” or “prostate carcinoma”. Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible. Results: Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80–0.86), the specificity of 0.77 (95% CI: 0.74–0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39–0.73) and specificity of 0.99 (95% CI: 0.94–1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63–0.73), and specificity of 0.68 (95% CI: 0.60–0.75). Conclusion: This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.

scholarly journals Study of the Efficacy of PET/CT in Lung Aspiration Biopsy and Factors Associated with False-Negative Results

2018 ◽  
Vol 79 (3) ◽  
pp. 129
Author(s):  
Il Wan Son ◽  
Ji Won Lee ◽  
Yeon Joo Jeong ◽  
Ahrong Kim ◽  
Hie Bum Suh ◽  
...  
Keyword(s):  
False Negative ◽  
Aspiration Biopsy ◽  
Factors Associated ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct

Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET/CT vs PET/MRI

2021 ◽  
Author(s):  
Feng-Yuan Liu ◽  
Ting-Wen Sheng ◽  
Jing-Ren Tseng ◽  
Kai-Jie Yu ◽  
Ke-Hong Tsui ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Tumor Staging ◽  
Distant Metastases ◽  
Local Tumor ◽  
Pet Ct ◽  
Primary Tumor Detection

Objectives: To investigate whether PET/CT or PET/MRI is more appropriate for imaging prostate cancer, in terms of for primary tumor detection, local staging and recurrence, as well as lymph nodes and distant metastases. Methods: A systematic literature search was conducted on Embase, PubMed/MEDLINE, and the Cochrane Library database. Studies evaluating the diagnostic performance of PET/CT vs PET/MRI in prostate cancer patients were emphasized. Results: We reviewed 57 original research articles during the period 2016—2021: 14 articles regarding the radiotracer PSMA; 18 articles regarding the primary tumor detection, local tumor staging, managing local recurrence; 17 articles for managing lymph node metastases; and eight articles for managing bone and other distant metastases. PSMA PET could be complementary to mpMRI for primary prostate cancer localization and is particularly valuable for PI-RADS three lesions. PET/MRI is better than PET/CT in local tumor staging due to its specific benefit in predicting extracapsular extension in MRI-occult prostate cancer patients. PET/MRI is likely superior as compared with PET/CT in detecting local recurrence, and have slightly higher detection rates than PET/CT in lymph node recurrence. PET/CT and PET/MRI seem to have equivalent performance in detecting distant bony or visceral metastases. Conclusion: In conclusion, PET/MRI is suitable for local and regional disease, either primary staging or restaging whereas PET/CT is valuable for managing distant bony or visceral metastasis. Advances in knowledge: We reviewed the emerging applications of PET/MRI and PET/CT in clinical aspects. Readers will gain an objective overview on the strength and shortfalls of PET/MRI or PET/CT in the management of prostate cancer.

Transhepatic forceps biopsy after PTCD for histological assessment of bile duct stenoses or occlusions

2019 ◽  
Vol 57 (02) ◽  
pp. 133-138
Author(s):  
Eva-Marie Warnken ◽  
Michael Uder ◽  
Hubert Stein ◽  
Michael Wucherer ◽  
Michael Lell ◽  
...  
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Short Term ◽  
Microsoft Excel ◽  
Ct Guided ◽  
Forceps Biopsy ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct ◽  
Ct Guided Biopsy

Abstract Purpose The goal of this study was to evaluate the experience of 11 years of wire-guided forceps biopsy via PTCD in patients with obstructive jaundice. Materials and methods In a retrospective approach, 56 biopsies in 51 patients were analyzed (22 female, 29 male). Data was collected from 2006 to 2016. Mean age was 71 years (range: 34 – 86 years). Data was extracted from dig. Patients’ records (KIS, PACS, RIS) to be analyzed in Microsoft Excel. Results All 56 procedures were technically successful. Stenosis in anastomoses were benign due to scarring in 7 patients and in 9 due to papillitis or others. In 4 patients, results in anastomosis were malignant. In 19 patients without anastomosis, CCC was the diagnosis, thereof 10 klatskin, 9 stenosis in other locations, followed by gastric, pancreatic, and colon carcinoma in 5, 3, and 2 patients. Three patients had a CUP (multimetering in case of more than 1 related category). Overall results were 35 mal. and 16 benign, 76.8 % of all proc. had a correct histopathologic result, and 23.2 % were false negative. Sensitivity was 65.8 %, which results in negative predictive value of 58.1 %. There was no false positive and so specificity was 100 %, as was the positive predictive value. False negative results (no malignancy but clinically and imaging suspect) were corrected by rerunning the procedure, by CT-guided biopsy or by 1 PET-CT. In 1 case the surg. sample brought the result. Minor complications occurred in 8 patients: shivering in 1 case, distinct but hemodynamically not relevant hemobilia in 5 cases, 2 portovenal bleedings. All bleedings were short-term and self-limiting. Conclusion Despite good feasibility, low peri- and post-interv. risk and high validity the forceps biopsy via PTCD is not widely used. For experienced interventionalists, it is an effective method for obtaining histology.

PS02.064: ACCURACY OF F-18-FDG-PET/CT IN MONITORING TUMOUR RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH OESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 138-139
Author(s):  
Maria Valkema ◽  
B Noordman ◽  
Bas P L Wijnhoven ◽  
M C W Spaander ◽  
Sjoerd M Lagarde ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Conflicts Of Interest ◽  
False Negative ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumour Response ◽  
Distant Metastases ◽  
Residual Tumour ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background Neoadjuvant chemoradiotherapy (nCRT) induces a pathologically complete response in approximately 30% of patients with oesophageal cancer. To explore the possibility of safe postponement of surgery, accurate clinical response evaluations are needed to exclude residual disease. The present study aims to assess the value of F-18-FDG-PET/CT for the detection of residual tumour (> 10% tumour cells = TRG3–4 vs. no vital cells = TRG1) or metastases after nCRT. Methods FDG-PET/CT at baseline and 12 weeks after nCRT was performed according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.) and the protocol of the preSANO study. Qualitative analysis included sensitive reading of presence of residual tumour and/or metastases. A lesion was considered FDG-positive, when any uptake in the lesion itself was above the adjacent oesophageal background uptake. Quantitatively, SUV/lean body mass (SUL) measurements at tumour, lymph nodes, oesophagus, liver and bloodpool were recorded and compared with pathology (resection specimen: gold standard). Results Some 129 of 207 patients with FDG-avid tumours at baseline proceeded to FDG-PET/CT at around 12 weeks after nCRT just before surgery. Forty-one of 129 patients had TRG3–4, of whom 6 were missed on FDG-PET/CT (15% false negative) with SULmax 2.07 ± 0.25, SUL-ratio tumour/oesophagus (SULR) 1.35 ± 0.14. Sensitivity for TRG2–3-4 vs. TRG1 was 57/71 (80%). SULmax and SULR of FDG-positives were 3.76 ± 1.33 and 1.82 ± 0.69 respectively, compared to SULmax 2.21 ± 0.42 and SULR 1.31 ± 0.22 in FDG-negatives. Distant metastases were detected in 18 of 190 (10%) patients. Of all patients with postponed surgery, 12 had ≥ 1 additional FDG-PET/CT during follow-up (25–49.7 weeks after nCRT). Eventually, 4 patients underwent surgery. Three of 4 had increased FDG-signal and TRG3–4; 1 patient had decreased FDG-signal and no tumour left (TRG1). Conclusion FDG-PET/CT at around 12 weeks after nCRT misses TRG3–4 tumours in 15% and detects residual TRG2–3-4 in 80%. Furthermore, PET-CT detects distant metastases in 10% of patients after nCRT. These data indicate that serial FDG-PET may become valuable in an active surveillance approach. Disclosure All authors have declared no conflicts of interest.

scholarly journals Sensitivity of prostate cancer foci using 1.5 T multiparametric magnetic resonance imaging

2020 ◽  
Author(s):  
Suguru Ito ◽  
SEI NAITO ◽  
Takafumi Narisawa ◽  
Mayu Yagi ◽  
Yuta Kurota ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
False Negative ◽  
Resonance Imaging ◽  
Prostate Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Negative Results ◽  
False Negative Results ◽  
Clinically Significant

Abstract Background The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP. Methods A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥ 3 + 4 (GS ≥ 3 + 4 or diameter > 10 mm) and csCaP/GS ≥ 4 + 3 (GS ≥ 4 + 3 or diameter > 10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥ 3. Results The sensitivity of all legions, csCaP/GS ≥ 3 + 4, csCaP/GS ≥ 4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥ 3 + 4. There were three lesions with a GS of ≥ 8 and ≥ 10 mm in the false-negative results. Conclusions mpMRI can highly detect ITs and csCaP/GS ≥ 4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.

scholarly journals MODERN OPPORTUNITIES OF PET/CT IN THE DIAGNOSIS OF PROSTATE CANCER

2021 ◽  
Vol 20 (5) ◽  
pp. 115-122
Author(s):  
V. V. Vyazmin ◽  
R. A. Zukov ◽  
N. G. Chanchikova ◽  
E. A. Levchenko ◽  
V. I. Chernov
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
English Language ◽  
Distant Metastases ◽  
Emission Computed Tomography ◽  
Positron Emission ◽  
Primary Prostate Cancer ◽  
Pet Ct ◽  
Sensitivity Specificity ◽  
Diagnostic Capabilities

The purpose is to present a modern data on the possibilities of positron emission computed tomography combined with computed tomography (PET/CT) in the diagnosis, staging and monitoring of prostate cancer (PC).Material and Methods. A search and analysis of the largest domestic and English-language databases (Elibrary, PubMed, Elsevier, etc.) on this problem was carried out. 37 sources were found devoted to studying the results of clinical trials of the diagnostic capabilities of PET/CT with various radiopharmaceuticals.Results. The presented data on the possibilities of PET/CT with various radiopharmaceuticals in the diagnosis of primary prostate cancer, imaging of lymphogenous and distant metastases, as well as in assessing the effectiveness of treatment.Conclusion. This review of the literature showed that the use of PET/CT in prostate cancer largely depends on the chosen radiopharmaceutical. Moreover, it is PET/CT with PSMA-based radiopharmaceuticals that is the most promising method for examining patients with prostate cancer and can be recommended as an additional study in cases where other methods of radiation diagnostics do not give an unambiguous answer. The development of new and improving the already used radiopharmaceuticals, which will increase the sensitivity, specificity and accuracy of the diagnosis, staging, monitoring and prognosis of treatment of prostate cancer, remains relevant.

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