PT  - JOURNAL ARTICLE
AU  - Mohsen Farsad
AU  - Riccardo Schiavina
AU  - Paolo Castellucci
AU  - Cristina Nanni
AU  - Barbara Corti
AU  - Giuseppe Martorana
AU  - Romeo Canini
AU  - Walter Grigioni
AU  - Stefano Boschi
AU  - Mario Marengo
AU  - Cinzia Pettinato
AU  - Eugenio Salizzoni
AU  - Nino Monetti
AU  - Roberto Franchi
AU  - Stefano Fanti
TI  - Detection and Localization of Prostate Cancer: Correlation of <sup>11</sup>C-Choline PET/CT with Histopathologic Step-Section Analysis
DP  - 2005 Oct 01
TA  - Journal of Nuclear Medicine
PG  - 1642--1649
VI  - 46
IP  - 10
4099  - http://jnm.snmjournals.org/content/46/10/1642.short
4100  - http://jnm.snmjournals.org/content/46/10/1642.full
SO  - J Nucl Med2005 Oct 01; 46
AB  - This study evaluated the potential usefulness of 11C-choline PET/CT for detection and localization of tumors within the prostate. We used the results of step-section histopathologic examination as the standard of reference. Methods: The results were analyzed on a sextant basis. We reviewed the results of the 11C-choline PET/CT scans of 36 patients with prostate cancer and of 5 control subjects with bladder cancer. All patients underwent 11C-choline PET/CT and, subsequently, radical prostatectomy with lymph node dissection within 1 mo. 11C-Choline PET/CT scans were obtained 5–10 min after intravenous injection of 370–555 MBq of 11C-choline. Images were reviewed visually and semiquantitatively using maximum SUV and tumor-to-background ratio. Results: On a sextant basis, histopathologic analysis detected cancer foci in 143 of 216 sextants; high-grade prostate intraepithelial neoplasm foci were detected in 89 of 216 sextants (in 59 sextants in association with carcinoma, in 30 sextants alone), acute prostatitis was detected in 7 of 216 sextants (in 3 sextants in association with carcinoma, in 4 sextants alone), and 39 of 216 sextants were normal. PET/CT demonstrated focal 11C-choline uptake in 108 sextants (94 of which involved tumor), and 108 sextants showed no abnormal 11C-choline uptake (49 of which were false negative). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT were 66%, 81%, 71%, 87%, and 55%, respectively. In the 5 control subjects, high-grade prostate intraepithelial neoplasm was detected at histologic examination in 16 of 30 sextants. PET/CT showed increased 11C-choline uptake in 5 of 16 sextants. Conclusion: This study demonstrated the feasibility of using 11C-choline PET/CT to identify cancer foci within the prostate. However, we also found that 11C-choline PET/CT has a relative high rate of false-negative results on a sextant basis and that prostatic disorders other than cancer may accumulate 11C-choline. Therefore, our data do not support the routine use of PET/CT with 11C-choline as a first-line screening procedure for prostate cancer in men at high risk.