Calabria Ferdinando, Chiaravalloti Agostino, Tavolozza Mario, Ragano-Caracciolo Cristiana, Schillaci Orazio
Department of Nuclear Medicine and Molecular Imaging, INM IRCCS Neuromed, Pozzilli, Rome, Italy.
Nucl Med Commun. 2013 Aug;34(8):733-40. doi: 10.1097/MNM.0b013e3283620d5e.
The aim of our study was to evaluate the accuracy of F-18 choline positron emission tomography/computed tomography (PET/CT) in assessing the presence of extraprostatic disease during staging of prostate cancer, in relation to prostate-specific antigen (PSA) and PSA density, a PSA derivative that is useful for improving risk stratification in prostate cancer patients.
F-18 choline PET/CT was performed in 45 patients for early staging of biopsy-proven prostate cancer. None of the examined patients had received therapy before the examination. In all of them a transrectal ultrasonography had been performed earlier to calculate the prostate volume and PSA density. The mean PSA value was 25.5 (±38.1) ng/ml, whereas the mean PSA density was 0.70 (±0.88).
Results of F-18 choline PET/CT were related to PSA and PSA density. PET/CT was positive for extraprostatic disease in 18/45 patients (40%) (mean PSA and PSA density were, respectively, 44.08 ng/ml and 1.08); PET/CT was negative for extraprostatic disease in 27/45 patients (60%) (mean PSA and PSA density were, respectively, 13.12 ng/ml and 0.4). PET/CT was positive in 13/18 patients (72%) with a PSA cutoff value greater than or equal to 18 ng/ml and in 5/21 (24%) with a PSA value less than 18 ng/ml (P=0.0017). PET/CT was positive in 16/18 patients (89%) with PSA density greater than or equal to 0.31 and in 2/18 (11%) with PSA density lower than 0.31 (P=0.0234).
The possibility of detecting extraprostatic disease of prostate cancer with F-18 choline PET/CT is related to PSA and PSA density. In particular, F-18 choline PET/CT should be recommended only in patients with a PSA value of at least 18 ng/ml, whereas a PSA density of at least 0.31 ng/ml is more probably associated with distant metastases.
我们研究的目的是评估F-18胆碱正电子发射断层扫描/计算机断层扫描（PET/CT）在前列腺癌分期过程中评估前列腺外疾病存在情况的准确性，以及与前列腺特异性抗原（PSA）和PSA密度的关系，PSA密度是一种有助于改善前列腺癌患者风险分层的PSA衍生指标。
对45例经活检证实的前列腺癌患者进行F-18胆碱PET/CT检查以进行早期分期。所有受检患者在检查前均未接受过治疗。所有患者均在更早之前进行了经直肠超声检查以计算前列腺体积和PSA密度。PSA平均值为25.5（±38.1）ng/ml，而PSA密度平均值为0.70（±0.88）。
F-18胆碱PET/CT的结果与PSA和PSA密度相关。PET/CT显示18/45例患者（40%）存在前列腺外疾病阳性（PSA和PSA密度平均值分别为44.08 ng/ml和1.08）；PET/CT显示27/45例患者（60%）不存在前列腺外疾病阳性（PSA和PSA密度平均值分别为13.12 ng/ml和0.4）。PSA临界值大于或等于18 ng/ml的患者中，13/18例（72%）PET/CT为阳性，PSA值小于18 ng/ml的患者中5/21例（24%）PET/CT为阳性（P=0.0017）。PSA密度大于或等于0.31的患者中，16/18例（89%）PET/CT为阳性，PSA密度低于0.31的患者中2/18例（11%）PET/CT为阳性（P=0.0234）。
F-18胆碱PET/CT检测前列腺癌前列腺外疾病的可能性与PSA和PSA密度相关。特别是，仅应建议PSA值至少为18 ng/ml的患者进行F-18胆碱PET/CT检查，而PSA密度至少为0.31 ng/ml更可能与远处转移相关。
