RT Journal Article
SR Electronic
T1 Functional Imaging of Localized Prostate Cancer Aggressiveness Using <sup>11</sup>C-Acetate PET/CT and <sup>1</sup>H-MR Spectroscopy
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1676
OP 1683
DO 10.2967/jnumed.110.078667
VO 51
IS 11
A1 Jambor, Ivan
A1 Borra, Ronald
A1 Kemppainen, Jukka
A1 Lepomäki, Virva
A1 Parkkola, Riitta
A1 Dean, Kirsti
A1 Alanen, Kalle
A1 Arponen, Eveliina
A1 Nurmi, Martti
A1 Aronen, Hannu J.
A1 Minn, Heikki
YR 2010
UL http://jnm.snmjournals.org/content/51/11/1676.abstract
AB We assessed the ability of 11C-acetate PET/CT, MRI, and proton MR spectroscopy (1H-MRS) to image localized prostate cancer and detect its aggressiveness, using qualitative and quantitative approaches. Methods: Twenty-one patients with untreated localized prostate cancer, diagnosed using transrectal ultrasound-guided biopsy, were prospectively enrolled. Cancer laterality was based on the percentage of cancer and the highest Gleason score determined from biopsies. In addition to PET/CT, 3-dimensional 1H-MRS of the entire prostate volume using a quantitative approach was performed. The imaging and histologic findings of 8 patients undergoing subsequent prostatectomy were compared on a sextant level. For each lobe and sextant, standardized uptake values (SUVs) and (choline + creatine + polyamines)–to–citrate (CCP/C) ratios were obtained from 11C-acetate PET/CT and 1H-MRS, respectively. The visual and quantitative findings on PET/CT and MRI data were compared with cancer laterality and aggressiveness based on the Gleason score and with prostate-specific antigen (PSA) velocity and international risk group classification. Results: The sensitivity, specificity, and accuracy, on a lobar level using visual analysis, of 11C-acetate PET/CT were 80%, 29%, 71%, respectively, and 89%, 29%, 79%, respectively, using contrast-enhanced MRI. The sensitivity and accuracy of 11C-acetate PET/CT decreased to 64% and 63% and specificity increased to 62% when sextant analysis was performed. The agreement between prostate cancer laterality based on biopsy findings and visual interpretation of 11C-acetate PET/CT and contrast-enhanced MRI was similar at 71%. The mean SUV maximum and CCP/C maximum for the dominant tumor lesion were 5.5 and 1.48, respectively, and did not differ significantly from values in the nondominant lobe. The dominant-lesion SUVs or CCP/C values were not associated with histologically determined prostate cancer aggressiveness, nor did PSA velocity correlate with the SUV or CCP/C values from the entire gland. Conclusion: 11C-acetate PET/CT, MRI, and 1H-MRS enable detection of localized prostate cancer with comparable and limited accuracy but fail to provide information on cancer aggressiveness.