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Research ArticleClinical Investigations

Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients

Marino Cimitan, Laura Evangelista, Marina Hodolič, Giuliano Mariani, Tanja Baseric, Valentina Bodanza, Giorgio Saladini, Duccio Volterrani, Anna Rita Cervino, Michele Gregianin, Giulia Puccini, Federica Guidoccio, Jure Fettich and Eugenio Borsatti
Journal of Nuclear Medicine February 2015, 56 (2) 209-215; DOI: https://doi.org/10.2967/jnumed.114.141887
Marino Cimitan
1Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, Italy
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Laura Evangelista
2Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology, IRCCS, Padua, Italy
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Marina Hodolič
3Nuclear Medicine Department, University Medical Center Ljubljana, Ljubljana, Slovenia; and
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Giuliano Mariani
4Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy
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Tanja Baseric
1Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, Italy
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Valentina Bodanza
1Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, Italy
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Giorgio Saladini
2Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology, IRCCS, Padua, Italy
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Duccio Volterrani
4Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy
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Anna Rita Cervino
2Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology, IRCCS, Padua, Italy
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Michele Gregianin
2Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology, IRCCS, Padua, Italy
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Giulia Puccini
4Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy
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Federica Guidoccio
4Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy
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Jure Fettich
3Nuclear Medicine Department, University Medical Center Ljubljana, Ljubljana, Slovenia; and
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Eugenio Borsatti
1Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, Italy
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  • FIGURE 1.
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    FIGURE 1.

    Distributions of Gleason scores and PSA cutoff values. doubt = doubtful; neg = negative; pos = positive.

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    FIGURE 2.

    ROC analysis. Values of 1.5 ng/mL for serum PSA and 7 for Gleason score (GS) were defined as best cutoff values for predicting positive 18F-choline PET/CT scan. AUC = area under the curve.

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    TABLE 1

    Main Characteristics of the Patients

    CharacteristicValue
    Age (y)*69.68 ± 7.67
    Center
     CRO626 (62.6)
     Medical Center Ljubljana79 (7.9)
     IOV227 (22.7)
     University of Pisa68 (6.8)
    GS
     ≤6257 (25.7)
     7347 (34.7)
     >7396 (39.6)
    Actual GS
     22 (0.2)
     34 (0.4)
     49 (0.9)
     543 (4.3)
     6199 (19.9)
     7347 (34.7)
     8223 (22.3)
     9155 (15.5)
     1018 (1.8)
    Primary treatment
     Surgery alone353 (35.3)
     Surgery and adjuvant EBRT (with or without HT)167 (16.7)
     EBRT (with or without HT)152 (15.2)
     HT alone121 (12.1)
     NA207 (20.7)
    PSA level, in ng/mL†3.30 (1.15–11.0)
    • ↵* Reported as mean ± SD.

    • ↵† Reported as median (IQR).

    • CRO = IRCCS National Cancer Institute; IOV = Veneto Institute of Oncology; EBRT = external beam radiotherapy; HT = hormone therapy; NA = not available.

    • Values are reported as number of patients followed by percentage in parentheses unless otherwise indicated.

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    TABLE 2

    Correlations Between Clinical Characteristics of Patients and PET/CT Findings

    CharacteristicNegative PET/CTPositive PET/CTDoubtful PET/CTP
    n30064555
    PSA level, in ng/mL*1.20 (0.58–2.35)6.65 (2.56–17.47)1.8 (0.85–3.9)0.073†
    PSA range
     <1 ng/mL127 (42.3)66 (10.2)18 (32.7)<0.001‡
     ≥1 but <2 ng/mL74 (24.7)66 (10.2)13 (23.6)
     ≥2 ng/mL99 (33)513 (79.5)24 (43.6)
    GS
     ≤6113 (37.7)127 (19.7)17 (30.9)<0.001‡
     7120 (40)206 (31.9)21 (38.2)
     >767 (22.3)312 (48.4)17 (30.9)
    Type of therapy
     RP alone161 (53.7)162 (25.1)30 (54.5)<0.001‡
     RP and adjuvant EBRT (with or without HT)50 (16.7)107 (16.6)10 (18.2)
     EBRT (with or without HT)35 (11.7)113 (17.5)4 (7.3)
     HT alone10 (3.3)109 (16.9)2 (3.6)
     NA44 (14.7)154 (23.9)9 (16.4)
    • ↵* Reported as median (IQR).

    • ↵† ANOVA.

    • ↵‡ χ2 test.

    • RP = radical prostatectomy; EBRT = external-beam radiotherapy; HT = hormone therapy; NA = not available.

    • Values are reported as number of patients followed by percentage in parentheses unless otherwise indicated.

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    TABLE 3

    Univariate and Multivariate Analyses

    UnivariableMultivariable
    ParameterOR95% CIPOR95% CIP
    Age1.0351.016–1.054<0.0011.0251.003–1.048<0.05
    GS ≤ 6
    GS = 70.2410.167–0.348<0.0010.2260.145–0.3351<0.001
    GS > 70.3690.261–0.521<0.0010.3300.216–0.503<0.001
    Surgery (yes vs. no)1.4630.885–2.4160.138
    EBRT (yes vs. no)0.4660.303–0.717<0.052.2210.342–14.410.403
    HT (yes vs. no)0.3570.225–0.567<0.0011.00
    Ongoing HT (yes vs. no)0.4900.313–0.978<0.0051.00
    Chemotherapy (yes vs. no)0.4880.321–0.742<0.050.2030.074–0.560<0.05
    PSA of <1
    PSA ≥1 but <20.1000.069–0.145<0.0010.0920.060–0.141<0.001
    PSA of ≥20.1720.116–0.256<0.0010.2060.134–0.316<0.001
    • OR = odds ratio; CI = confidence interval; EBRT = external-beam radiotherapy; HT = hormonal therapy.

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Journal of Nuclear Medicine: 56 (2)
Journal of Nuclear Medicine
Vol. 56, Issue 2
February 1, 2015
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Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients
Marino Cimitan, Laura Evangelista, Marina Hodolič, Giuliano Mariani, Tanja Baseric, Valentina Bodanza, Giorgio Saladini, Duccio Volterrani, Anna Rita Cervino, Michele Gregianin, Giulia Puccini, Federica Guidoccio, Jure Fettich, Eugenio Borsatti
Journal of Nuclear Medicine Feb 2015, 56 (2) 209-215; DOI: 10.2967/jnumed.114.141887

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Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients
Marino Cimitan, Laura Evangelista, Marina Hodolič, Giuliano Mariani, Tanja Baseric, Valentina Bodanza, Giorgio Saladini, Duccio Volterrani, Anna Rita Cervino, Michele Gregianin, Giulia Puccini, Federica Guidoccio, Jure Fettich, Eugenio Borsatti
Journal of Nuclear Medicine Feb 2015, 56 (2) 209-215; DOI: 10.2967/jnumed.114.141887
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Keywords

  • 18F-choline PET
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