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- Kjölhede, Henrik, et al.
(författare)
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(18)F-choline PET/CT for early detection of metastases in biochemical recurrence following radical prostatectomy.
- 2015
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Ingår i: World Journal of Urology. - : Springer Science and Business Media LLC. - 1433-8726 .- 0724-4983. ; 33:11, s. 1749-1752
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Tidskriftsartikel (refereegranskat)abstract
- Salvage radiotherapy (SRT) for biochemical recurrence (BCR) following radical prostatectomy (RP) should if possible be added at a prostate-specific antigen (PSA) level of <1-2 ng/mL. The value of positron emission tomography combined with computed tomography (PET/CT) at such low PSA values is not defined. The purpose was to determine what proportion of a well-defined cohort of hormone-naïve patients who were candidates for early salvage radiotherapy had (18)F-choline PET/CT findings suggesting metastases.
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| 2. |
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| 3. |
- Kjölhede, Henrik, et al.
(författare)
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Combined (18) F-fluorocholine and (18) F-fluoride positron emission tomography/computed tomography imaging for staging of high-risk prostate cancer.
- 2012
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Ingår i: BJU International. - 1464-4096. ; 110:10, s. 1501-1506
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Tidskriftsartikel (refereegranskat)abstract
- Study Type - Diagnosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Positron emission tomography/computed tomography (PET/CT) with choline and fluoride for the detection of metastases in patients with prostate cancer have each been evaluated, with mixed results. Choline PET/CT has been evaluated against pelvic lymphadenectomy, generally with a low sensitivity but a high specificity; however, the study populations have been heterogenous. Fluoride PET/CT has been evaluated against other imaging methods, such as bone scan, single photon emission CT and MRI, and has been shown to have high specificity as well as sensitivity for bone metastases, but there are no studies with biopsy verification. This is the first study that evaluates the clinical use of both choline and fluoride PET/CT on the same patients in a well-defined population of patients with high-risk prostate cancer. OBJECTIVE: • To investigate how often positron emission tomography/computed tomography (PET/CT) scans, with both (18) F-fluorocholine and (18) F-fluoride as markers, add clinically relevant information for patients with prostate cancer who have high-risk tumours and a normal or inconclusive planar bone scan. PATIENTS AND METHODS: • Patients with prostate cancer with prostate specific antigen (PSA) levels between 20 and 99 ng/mL and/or Gleason score 8-10 tumours, planned for treatment with curative intent based on routine staging with a negative or inconclusive bone scan, were further investigated with a (18) F-fluorocholine and a (18) F-fluoride PET/CT. • None of the patients received hormonal therapy before the staging procedures were completed. RESULTS: • For 50 of the 90 included patients (56%) one or both PET/CT scans indicated metastases. • (18) F-fluorocholine PET/CT indicated lymph node metastases and/or bone metastases in 35 patients (39%). • (18) F-fluoride PET/CT was suggestive for bone metastases in 37 patients (41%). • In 18 patients (20%) the PET/CT scans indicated widespread metastases, leading to a change in therapy intent from curative to non-curative. • Of the patients with positive scans, 74% had Gleason score 8-10 tumours. Of the patients with Gleason score 8-10 tumours, 64% had positive scans. CONCLUSIONS: • PET/CT scans with (18) F-fluorocholine and (18) F-fluoride commonly detect metastases in patients with high-risk prostate cancer and a negative or inconclusive bone scan. • For 20% of the patients the results of the PET/CT scans changed the treatment plan.
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| 4. |
- Kjölhede, Henrik, 1981, et al.
(författare)
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Pre-treatment 18F-choline PET/CT is prognostic for biochemical recurrence, development of bone metastasis, and cancer specific mortality following radical local therapy of high-risk prostate cancer.
- 2018
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Ingår i: European Journal of Hybrid Imaging. - : Springer Science and Business Media LLC. - 2510-3636. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine whether lymph node metastasis on pre-treatment 18F-choline PET/CT is an independent prognostic factor for biochemical recurrence (BCR), skeletal metastasis, and cancer specific mortality (CSM), after radical local treatment (radical prostatectomy and/or radiotherapy) in men with high-risk prostate cancer. Medical records were reviewed for men with newly diagnosed high-risk prostate cancer who had pre-treatment 18F-choline positron emission tomography fused with computed tomography (PET/CT) scan for primary metastasis staging.Of 174 eligible men, 124 met the criteria for inclusion. The PET/CT scan was negative for metastasis in 97 (78%) men, inconclusive in 15 (12%), and positive in 12 (10%). The men with a positive PET/CT scan had significantly shorter time to BCR (p=0.02), time to skeletal metastasis (p=0.002), and time to prostate cancer specific death (p<0.001). On multivariable Cox regression analysis, including also tumour stage, Gleason score, and PSA, a non-negative PET/CT scan was the only significant covariate for time to BCR (HR 2.6, 95% CI 1.3-5.5) and time to skeletal metastasis (HR 2.7, 95% CI 1.3-5.9).In men with a newly diagnosed high-risk prostate cancer and a negative or inconclusive bone scan, 18F-choline uptake on PET/CT suggestive metastasis was associated with recurrence, progression to distant metastasis, and prostate cancer death. This strongly indicates that the choline uptakes represented metastasis and not false positive findings.
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