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18F-FACBC (anti1-amino-3-18F-fluorocyclobutane-1-carboxylic acid) versus 11C-choline PET/CT in prostate cancer relapse: results of a prospective trial
- Publication Year :
- 2016
-
Abstract
- PURPOSE: To compare the accuracy of 18F-FACBC and 11C-choline PET/CT in patients radically treated for prostate cancer presenting with biochemical relapse. METHODS: This prospective study enrolled 100 consecutive patients radically treated for prostate cancer and presenting with rising PSA. Of these 100 patients, 89 were included in the analysis. All had biochemical relapse after radical prostatectomy (at least 3 months previously), had 11C-choline and 18F-FACBC PET/CT performed within 1 week and were off hormonal therapy at the time of the scans. The two tracers were compared directly in terms of overall positivity/negativity on both a per-patient basis and a per-site basis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated for both the tracers; follow-up at 1 year (including correlative imaging, PSA trend and pathology when available) was considered as the standard of reference. RESULTS: In 51 patients the results were negative and in 25 patients positive with both the tracers, in eight patients the results were positive with 18F-FACBC but negative with 11C-choline, and in five patients the results were positive with 11C-choline but negative with 18F-FACBC. Overall in 49 patients the results were false-negative (FN), in two true-negative, in 24 true-positive (TP) and in none false-positive (FP) with both tracers. In terms of discordances between the tracers: (1) in one patient, the result was FN with 11C-choline but FP with 18F-FACBC (lymph node), (2) in seven, FN with 11C-choline but TP with 18F-FACBC (lymph node in five, bone in one, local relapse in one), (3) in one, FP with 11C-choline (lymph node) but TP with 18F-FACBC (local relapse), (4) in two, FP with 11C-choline (lymph nodes in one, local relapse in one) but FN with 18F-FACBC, and (5) in three, TP with 11C-choline (lymph nodes in two, bone in one) but FN with 18F-FACBC. With 11C-choline and 18F-FACBC, sensitivities were 32 % and 37 %, specificities 40 % and 67 %, accuracies 32 % and 38 %, PPVs 90 % and 97 %, and NPVs 3 % and 4 %, respectively. Categorizing patients by PSA level (
- Subjects :
- Male
medicine.medical_specialty
PET/CT
medicine.medical_treatment
Carboxylic Acids
Urology
Bone Neoplasms
Choline
030218 nuclear medicine & medical imaging
03 medical and health sciences
Prostate cancer
PSA
0302 clinical medicine
Recurrence
Positron Emission Tomography Computed Tomography
Anti-3-18F-FACBC
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Carbon Radioisotopes
Prospective Studies
Prospective cohort study
False Negative Reactions
Lymph node
Aged
Aged, 80 and over
PET-CT
business.industry
Prostatectomy
Prostatic Neoplasms
General Medicine
Middle Aged
Prostate-Specific Antigen
Choline pet ct
medicine.disease
Fluciclovine
medicine.anatomical_structure
Lymphatic Metastasis
030220 oncology & carcinogenesis
Hormonal therapy
Lymph
11C-Choline
business
Nuclear medicine
Cyclobutanes
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....341e24502736aec27105b8216dc9ac1e