[ 11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer

Comparison with bone scintigraphy

Maria Picchio, Elena Giulia Spinapolice, Federico Fallanca, Cinzia Crivellaro, Giampiero Giovacchini, Luigi Gianolli, Cristina Messa

Research output: Contribution to journalArticle

124 Citations (Scopus)

Abstract

Purpose: The aim of this study was to evaluate the clinical usefulness of [ 11C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Methods: Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [ 11C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [ 11C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive antiandrogenic treatment. Results: Equivocal findings occurred in 1 of 78 (1%) cases in [ 11C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [ 11C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68-100%, 100-86% and 83-90%, respectively. Concordant findings between [ 11C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [ 11C] choline PET/CT did not significantly (p=0.30) differ between hormone-resistant patients (97%) and those who did not receive antiandrogenic treatment (95%). Conclusion: In clinical practice, [ 11C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [ 11C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [ 11C]choline PET/CT.

Original languageEnglish
Pages (from-to)13-26
Number of pages14
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume39
Issue number1
DOIs
Publication statusPublished - Jan 2012

Fingerprint

Choline
Radionuclide Imaging
Positron-Emission Tomography
Prostatic Neoplasms
Neoplasm Metastasis
Bone and Bones
Therapeutics
Hormones
Prostate-Specific Antigen
Sensitivity and Specificity

Keywords

  • [ C]choline
  • Bone metastases
  • Bone scintigraphy
  • PET/CT
  • Positron emission tomography
  • Prostate cancer recurrence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

[ 11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer : Comparison with bone scintigraphy. / Picchio, Maria; Spinapolice, Elena Giulia; Fallanca, Federico; Crivellaro, Cinzia; Giovacchini, Giampiero; Gianolli, Luigi; Messa, Cristina.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 39, No. 1, 01.2012, p. 13-26.

Research output: Contribution to journalArticle

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title = "[ 11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: Comparison with bone scintigraphy",
abstract = "Purpose: The aim of this study was to evaluate the clinical usefulness of [ 11C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Methods: Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [ 11C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [ 11C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive antiandrogenic treatment. Results: Equivocal findings occurred in 1 of 78 (1{\%}) cases in [ 11C]choline PET/CT and in 21 of 78 (27{\%}) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [ 11C]choline PET/CT were 89-89{\%}, 98-100{\%}, 96-100{\%}, 94-96{\%} and 95-96{\%}, respectively. For BS they were 100-70{\%}, 75-100{\%}, 68-100{\%}, 100-86{\%} and 83-90{\%}, respectively. Concordant findings between [ 11C]choline PET/CT and BS occurred in 55 of 78 (71{\%}) cases. The accuracy of [ 11C] choline PET/CT did not significantly (p=0.30) differ between hormone-resistant patients (97{\%}) and those who did not receive antiandrogenic treatment (95{\%}). Conclusion: In clinical practice, [ 11C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [ 11C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [ 11C]choline PET/CT.",
keywords = "[ C]choline, Bone metastases, Bone scintigraphy, PET/CT, Positron emission tomography, Prostate cancer recurrence",
author = "Maria Picchio and Spinapolice, {Elena Giulia} and Federico Fallanca and Cinzia Crivellaro and Giampiero Giovacchini and Luigi Gianolli and Cristina Messa",
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T1 - [ 11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer

T2 - Comparison with bone scintigraphy

AU - Picchio, Maria

AU - Spinapolice, Elena Giulia

AU - Fallanca, Federico

AU - Crivellaro, Cinzia

AU - Giovacchini, Giampiero

AU - Gianolli, Luigi

AU - Messa, Cristina

PY - 2012/1

Y1 - 2012/1

N2 - Purpose: The aim of this study was to evaluate the clinical usefulness of [ 11C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Methods: Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [ 11C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [ 11C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive antiandrogenic treatment. Results: Equivocal findings occurred in 1 of 78 (1%) cases in [ 11C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [ 11C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68-100%, 100-86% and 83-90%, respectively. Concordant findings between [ 11C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [ 11C] choline PET/CT did not significantly (p=0.30) differ between hormone-resistant patients (97%) and those who did not receive antiandrogenic treatment (95%). Conclusion: In clinical practice, [ 11C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [ 11C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [ 11C]choline PET/CT.

AB - Purpose: The aim of this study was to evaluate the clinical usefulness of [ 11C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Methods: Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [ 11C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [ 11C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive antiandrogenic treatment. Results: Equivocal findings occurred in 1 of 78 (1%) cases in [ 11C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [ 11C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68-100%, 100-86% and 83-90%, respectively. Concordant findings between [ 11C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [ 11C] choline PET/CT did not significantly (p=0.30) differ between hormone-resistant patients (97%) and those who did not receive antiandrogenic treatment (95%). Conclusion: In clinical practice, [ 11C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [ 11C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [ 11C]choline PET/CT.

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KW - Positron emission tomography

KW - Prostate cancer recurrence

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