Lymph nodal metastases: Diagnosis and treatment

N. Di Muzio, A. Fodor, G. Berardi, P. Mapelli, L. Gianolli, C. Messa, M. Picchio

Research output: Contribution to journalArticlepeer-review

Abstract

High risk prostate cancer patients have a significant risk to develop regional lymph node metastases, and this represent a major cause of biochemical failure. Although pelvic lymphadenectomy is the gold standard to assess the status of pelvic lymph nodes, a diagnostic imaging tool to non-invasively explore patients and to detect metastases, both in staging and in re-staging phase, would be of particular help in clinical management. In staging phase, while choline PET/CT specificity has been reported to be fairly high in lymph nodal detection, its sensitivity is not adequate due to its spatial resolution. Its role in the evaluation of patients with biochemical relapse or with suspected relapse has been successfully documented. In particular, choline PET/CT has great potential as a single step whole body diagnostic procedure to evaluate lymph nodal and bone metastatic involvement. Salvage lymph nodal dissection was recently listed as a possible experimental option for patients with nodal recurrent prostate cancer, even in the absence of solid prospective data. Radiation treatment for lymph-node recurrence is a therapeutic option evaluated in several studies, in particular by using stereotactic treatment or whole pelvic lymph-nodal irradiation plus a boost on choline PET/CT positive lymph nodes. In the present review an analysis of the specific role of choline PET/CT in guiding a specific treatment on lymph nodal site in prostate cancer patients is reported.

Original languageEnglish
Pages (from-to)421-429
Number of pages9
JournalQuarterly Journal of Nuclear Medicine and Molecular Imaging
Volume56
Issue number5
Publication statusPublished - Oct 2012

Keywords

  • Lymph node excision
  • Lymph nodes
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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