Abstract
1898
Objectives Prostate cancer is the fifth most common cancer among Singaporean males. Currently, there are limitations to diagnostic imaging modalities, especially in assessing nodal or bony spread. In this study, we aim to evaluate the use of 18-F-flurocholine (18F-FCH) PET/CT imaging in prostate cancer.
Methods This is a prospective clinical trial using 18F-FCH PET/CT imaging in patients with histological proven prostate cancer from February to November 2010. The images were interpreted by two Nuclear Medicine physicians independently with subsequent consensus reporting. 18F-FCH PET/CT findings were collaborated with other imaging modalities available (e.g. bone scan, CT, MRI, ultrasound etc.) and histology. Sensitivity, specificity, positive and negative predictive values and overall accuracy were calculated for local (prostate), nodal and bone disease.
Results Eighteen patients were recruited; 11 newly diagnosed and seven with recurrent disease. Of the 11 newly diagnosed patients, nine had additional imaging. Among those with recurrent disease, six out of seven had additional imaging. 18F-FCH PET/CT has a sensitivity of 93% and specificity of 100% for local disease, a specificity of 86% for nodal disease (no sensitivity calculated as there are no true-positive results), and a sensitivity of 67% and specificity of 100% for bone disease. Overall, there are 17 true-positive scans, 13 true-negative scans, one false-positive scans and four false-negative scans, resulting in a sensitivity of 81%, a specificity of 93%, a positive predictive value of 94% and a negative predictive value of 76%. The overall accuracy is 86%.
Conclusions 18F-FCH PET/CT imaging may serve as an alternative imaging tool for prostate cancer. In particular, it has good sensitivity for local disease and an overall good specificity