Evaluation of extraprostatic disease in the staging of prostate cancer by F-18 choline PET/CT: Can PSA and PSA density help in patient selection?

Ferdinando Calabria, Agostino Chiaravalloti, Mario Tavolozza, Cristiana Ragano-Caracciolo, Orazio Schillaci

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVE: The aim of our study was to evaluate the accuracy of F-18 choline positron emission tomography/computed tomography (PET/CT) in assessing the presence of extraprostatic disease during staging of prostate cancer, in relation to prostate-specific antigen (PSA) and PSA density, a PSA derivative that is useful for improving risk stratification in prostate cancer patients. METHODS: F-18 choline PET/CT was performed in 45 patients for early staging of biopsy-proven prostate cancer. None of the examined patients had received therapy before the examination. In all of them a transrectal ultrasonography had been performed earlier to calculate the prostate volume and PSA density. The mean PSA value was 25.5 (±38.1) ng/ml, whereas the mean PSA density was 0.70 (±0.88). RESULTS: Results of F-18 choline PET/CT were related to PSA and PSA density. PET/CT was positive for extraprostatic disease in 18/45 patients (40%) (mean PSA and PSA density were, respectively, 44.08 ng/ml and 1.08); PET/CT was negative for extraprostatic disease in 27/45 patients (60%) (mean PSA and PSA density were, respectively, 13.12 ng/ml and 0.4). PET/CT was positive in 13/18 patients (72%) with a PSA cutoff value greater than or equal to 18 ng/ml and in 5/21 (24%) with a PSA value less than 18 ng/ml (P=0.0017). PET/CT was positive in 16/18 patients (89%) with PSA density greater than or equal to 0.31 and in 2/18 (11%) with PSA density lower than 0.31 (P=0.0234). CONCLUSION: The possibility of detecting extraprostatic disease of prostate cancer with F-18 choline PET/CT is related to PSA and PSA density. In particular, F-18 choline PET/CT should be recommended only in patients with a PSA value of at least 18 ng/ml, whereas a PSA density of at least 0.31 ng/ml is more probably associated with distant metastases.

Original languageEnglish
Pages (from-to)733-740
Number of pages8
JournalNuclear Medicine Communications
Volume34
Issue number8
DOIs
Publication statusPublished - Aug 2013

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Prostate-Specific Antigen
Choline
Patient Selection
Prostatic Neoplasms
Positron Emission Tomography Computed Tomography

Keywords

  • F-18 choline
  • Positron emission tomography/computed tomography
  • Prostate cancer
  • Prostate-specific antigen
  • Prostate-specific antigen density
  • Staging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Evaluation of extraprostatic disease in the staging of prostate cancer by F-18 choline PET/CT : Can PSA and PSA density help in patient selection? / Calabria, Ferdinando; Chiaravalloti, Agostino; Tavolozza, Mario; Ragano-Caracciolo, Cristiana; Schillaci, Orazio.

In: Nuclear Medicine Communications, Vol. 34, No. 8, 08.2013, p. 733-740.

Research output: Contribution to journalArticle

Calabria, Ferdinando ; Chiaravalloti, Agostino ; Tavolozza, Mario ; Ragano-Caracciolo, Cristiana ; Schillaci, Orazio. / Evaluation of extraprostatic disease in the staging of prostate cancer by F-18 choline PET/CT : Can PSA and PSA density help in patient selection?. In: Nuclear Medicine Communications. 2013 ; Vol. 34, No. 8. pp. 733-740.
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title = "Evaluation of extraprostatic disease in the staging of prostate cancer by F-18 choline PET/CT: Can PSA and PSA density help in patient selection?",
abstract = "OBJECTIVE: The aim of our study was to evaluate the accuracy of F-18 choline positron emission tomography/computed tomography (PET/CT) in assessing the presence of extraprostatic disease during staging of prostate cancer, in relation to prostate-specific antigen (PSA) and PSA density, a PSA derivative that is useful for improving risk stratification in prostate cancer patients. METHODS: F-18 choline PET/CT was performed in 45 patients for early staging of biopsy-proven prostate cancer. None of the examined patients had received therapy before the examination. In all of them a transrectal ultrasonography had been performed earlier to calculate the prostate volume and PSA density. The mean PSA value was 25.5 (±38.1) ng/ml, whereas the mean PSA density was 0.70 (±0.88). RESULTS: Results of F-18 choline PET/CT were related to PSA and PSA density. PET/CT was positive for extraprostatic disease in 18/45 patients (40{\%}) (mean PSA and PSA density were, respectively, 44.08 ng/ml and 1.08); PET/CT was negative for extraprostatic disease in 27/45 patients (60{\%}) (mean PSA and PSA density were, respectively, 13.12 ng/ml and 0.4). PET/CT was positive in 13/18 patients (72{\%}) with a PSA cutoff value greater than or equal to 18 ng/ml and in 5/21 (24{\%}) with a PSA value less than 18 ng/ml (P=0.0017). PET/CT was positive in 16/18 patients (89{\%}) with PSA density greater than or equal to 0.31 and in 2/18 (11{\%}) with PSA density lower than 0.31 (P=0.0234). CONCLUSION: The possibility of detecting extraprostatic disease of prostate cancer with F-18 choline PET/CT is related to PSA and PSA density. In particular, F-18 choline PET/CT should be recommended only in patients with a PSA value of at least 18 ng/ml, whereas a PSA density of at least 0.31 ng/ml is more probably associated with distant metastases.",
keywords = "F-18 choline, Positron emission tomography/computed tomography, Prostate cancer, Prostate-specific antigen, Prostate-specific antigen density, Staging",
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T1 - Evaluation of extraprostatic disease in the staging of prostate cancer by F-18 choline PET/CT

T2 - Can PSA and PSA density help in patient selection?

AU - Calabria, Ferdinando

AU - Chiaravalloti, Agostino

AU - Tavolozza, Mario

AU - Ragano-Caracciolo, Cristiana

AU - Schillaci, Orazio

PY - 2013/8

Y1 - 2013/8

N2 - OBJECTIVE: The aim of our study was to evaluate the accuracy of F-18 choline positron emission tomography/computed tomography (PET/CT) in assessing the presence of extraprostatic disease during staging of prostate cancer, in relation to prostate-specific antigen (PSA) and PSA density, a PSA derivative that is useful for improving risk stratification in prostate cancer patients. METHODS: F-18 choline PET/CT was performed in 45 patients for early staging of biopsy-proven prostate cancer. None of the examined patients had received therapy before the examination. In all of them a transrectal ultrasonography had been performed earlier to calculate the prostate volume and PSA density. The mean PSA value was 25.5 (±38.1) ng/ml, whereas the mean PSA density was 0.70 (±0.88). RESULTS: Results of F-18 choline PET/CT were related to PSA and PSA density. PET/CT was positive for extraprostatic disease in 18/45 patients (40%) (mean PSA and PSA density were, respectively, 44.08 ng/ml and 1.08); PET/CT was negative for extraprostatic disease in 27/45 patients (60%) (mean PSA and PSA density were, respectively, 13.12 ng/ml and 0.4). PET/CT was positive in 13/18 patients (72%) with a PSA cutoff value greater than or equal to 18 ng/ml and in 5/21 (24%) with a PSA value less than 18 ng/ml (P=0.0017). PET/CT was positive in 16/18 patients (89%) with PSA density greater than or equal to 0.31 and in 2/18 (11%) with PSA density lower than 0.31 (P=0.0234). CONCLUSION: The possibility of detecting extraprostatic disease of prostate cancer with F-18 choline PET/CT is related to PSA and PSA density. In particular, F-18 choline PET/CT should be recommended only in patients with a PSA value of at least 18 ng/ml, whereas a PSA density of at least 0.31 ng/ml is more probably associated with distant metastases.

AB - OBJECTIVE: The aim of our study was to evaluate the accuracy of F-18 choline positron emission tomography/computed tomography (PET/CT) in assessing the presence of extraprostatic disease during staging of prostate cancer, in relation to prostate-specific antigen (PSA) and PSA density, a PSA derivative that is useful for improving risk stratification in prostate cancer patients. METHODS: F-18 choline PET/CT was performed in 45 patients for early staging of biopsy-proven prostate cancer. None of the examined patients had received therapy before the examination. In all of them a transrectal ultrasonography had been performed earlier to calculate the prostate volume and PSA density. The mean PSA value was 25.5 (±38.1) ng/ml, whereas the mean PSA density was 0.70 (±0.88). RESULTS: Results of F-18 choline PET/CT were related to PSA and PSA density. PET/CT was positive for extraprostatic disease in 18/45 patients (40%) (mean PSA and PSA density were, respectively, 44.08 ng/ml and 1.08); PET/CT was negative for extraprostatic disease in 27/45 patients (60%) (mean PSA and PSA density were, respectively, 13.12 ng/ml and 0.4). PET/CT was positive in 13/18 patients (72%) with a PSA cutoff value greater than or equal to 18 ng/ml and in 5/21 (24%) with a PSA value less than 18 ng/ml (P=0.0017). PET/CT was positive in 16/18 patients (89%) with PSA density greater than or equal to 0.31 and in 2/18 (11%) with PSA density lower than 0.31 (P=0.0234). CONCLUSION: The possibility of detecting extraprostatic disease of prostate cancer with F-18 choline PET/CT is related to PSA and PSA density. In particular, F-18 choline PET/CT should be recommended only in patients with a PSA value of at least 18 ng/ml, whereas a PSA density of at least 0.31 ng/ml is more probably associated with distant metastases.

KW - F-18 choline

KW - Positron emission tomography/computed tomography

KW - Prostate cancer

KW - Prostate-specific antigen

KW - Prostate-specific antigen density

KW - Staging

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