RT Journal Article SR Electronic T1 Detection and Localization of Prostate Cancer: Correlation of 11C-Choline PET/CT with Histopathologic Step-Section Analysis JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1642 OP 1649 VO 46 IS 10 A1 Mohsen Farsad A1 Riccardo Schiavina A1 Paolo Castellucci A1 Cristina Nanni A1 Barbara Corti A1 Giuseppe Martorana A1 Romeo Canini A1 Walter Grigioni A1 Stefano Boschi A1 Mario Marengo A1 Cinzia Pettinato A1 Eugenio Salizzoni A1 Nino Monetti A1 Roberto Franchi A1 Stefano Fanti YR 2005 UL http://jnm.snmjournals.org/content/46/10/1642.abstract 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.