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Meeting ReportMultimodality and Non-radioactive Molecular Imaging: Oncology

Dynamic MRI and CAD vs. choline MRS vs. choline PET/CT: Where is the detection level for a lesion characterization in prostate cancer?

Michael Schmuecking, C. Boltze, H. Geyer, K. Kloetzer, B. Schilling, T. Wendt and C. Marx
Journal of Nuclear Medicine May 2009, 50 (supplement 2) 1024;
Michael Schmuecking
1Greiz County Hospital, Greiz, Germany
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C. Boltze
2University Teaching Hospital Waldklinikum, Gera, Germany
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H. Geyer
1Greiz County Hospital, Greiz, Germany
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K. Kloetzer
2University Teaching Hospital Waldklinikum, Gera, Germany
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B. Schilling
3FSU, Jena, Germany
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T. Wendt
3FSU, Jena, Germany
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C. Marx
1Greiz County Hospital, Greiz, Germany
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Abstract

1024

Objectives To evaluate prospectively the role of pre-interventional fused high resolution T2 MR images with parametrically analyzed dynamic contrast enhanced T1 MR images (DCE-MRI) and 1H MR spectroscopy (MRS) for a precise biopsy for the detection of prostate cancer and for radiation treatment planning of IMRT.

Methods Inclusion criteria: 55 pts with pathological PSA and/or previously negative TRUS-biopsy. Standardized biopsy of the prostate divided into 20 regions. Image fusion of colored parametric maps derived from DCE-MRI and MRS (single voxel spectroscopy, SVS; chemical shift imaging, CSI) with T2 images. Correlation with histology and cytokeratin (CK34βE1.2) positive areas in prostatectomy species and with choline PET/CT.

Results DCE-MRI: Sensitivity 82%, specificity 89%, accuracy 88%, PPV 61%, NPV 96%. SVS: Sensitivity 55%, specificity 62%. CSI: Sensitivity 68%, specificity 67%. False positive findings due to prostatitis, adenomatous hyperplasia, false negative findings due to low signal (PIN, cut-off level for DCE-MRI: lesions smaller 3mm and less than 30% cancer cells, for SVS: lesions smaller 8mm and less than 50% cancer cells, for CSI: lesions smaller 4mm and less than 40% cancer cells).

Conclusions Choline PET/CT is superior to choline MRS. Similar accuracy of DCE-MRI and choline PET/CT. DCE-MRI and MRS are helpful for a precise biopsy of the prostate. The ESTRO-guidelines 2006 for radiation treatment planning of the prostate have to be revised, if the standardized biopsy will be replaced by a lesion orientated biopsy. Till now it is unclear, if the parametric maps of DCE-MRI and MRS can be used for IMRT of the prostate.

  • © 2009 by Society of Nuclear Medicine
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Journal of Nuclear Medicine
Vol. 50, Issue supplement 2
May 2009
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Dynamic MRI and CAD vs. choline MRS vs. choline PET/CT: Where is the detection level for a lesion characterization in prostate cancer?
Michael Schmuecking, C. Boltze, H. Geyer, K. Kloetzer, B. Schilling, T. Wendt, C. Marx
Journal of Nuclear Medicine May 2009, 50 (supplement 2) 1024;

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Dynamic MRI and CAD vs. choline MRS vs. choline PET/CT: Where is the detection level for a lesion characterization in prostate cancer?
Michael Schmuecking, C. Boltze, H. Geyer, K. Kloetzer, B. Schilling, T. Wendt, C. Marx
Journal of Nuclear Medicine May 2009, 50 (supplement 2) 1024;
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