Adult urologyFluorodeoxyglucose positron emission tomography studies in diagnosis and staging of clinically organ-confined prostate cancer
Section snippets
Patients
Twenty-four patients with clinically organ-confined prostate cancer were investigated. None of the patients had undergone any therapeutic modality or invasive surgical procedures for treatment of their prostate cancer. The average age of the 24 patients in the study was 66.9 years (range 56 to 85), and the average PSA was 13.6 ng/mL (range 3.7 to 28.1). Prostate volumes were measured by transrectal ultrasonography and ranged from 18.5 to 123.9 cc (mean 53.3). Of the 24 patients, there were 20
Results
Of the 24 patients imaged for clinically organ-confined prostate cancer, 1 patient had Gleason grade 3+2 adenocarcinoma, 13 patients had grade 3+3, 4 patients had grade 3+4, 3 patients had grade 4+3, 3 patients had grade 4+4, and 1 patient had grade 5+4 prostate cancer. One of the 24 patients was diagnosed with Stage T1A tumor, 8 with Stage T1C, 12 with Stage T2B, and 3 with Stage T2A. In the 10 patients undergoing radical prostatectomy, tumor volumes ranged from 1.2 to 10.4 cc (mean 6.9). One
Comment
Many studies have reinforced the superior accuracy of PET over conventional modalities, such as computerized tomography (CT) or magnetic resonance imaging, for the staging of cancer. Ogunbiyi et al.7 have shown that PET is more sensitive than CT in the clinical assessment of patients with recurrent or metastatic colorectal cancer. Lucas et al.9 reported that FDG PET was also instrumental in identifying local recurrence and pulmonary metastases in patients with soft-tissue sarcomas after
Conclusions
FDG PET scan is not a useful test in the diagnosis of organ-confined prostate cancer. This lack of usefulness persists even after elimination of problematic urinary isotope and uptake by BPH that have plagued prior studies evaluating this modality.
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