18F-氟胆碱 PET/CT 补充动态对比增强 MRI 的作用，为根治性前列腺切除术后疑似复发的前列腺癌患者提供全面的诊断评估。

18F-Fluorocholine PET/CT Complementing the Role of Dynamic Contrast-Enhanced MRI for Providing Comprehensive Diagnostic Workup in Prostate Cancer Patients With Suspected Relapse Following Radical Prostatectomy.

机构信息

From the Departments of *Nuclear Medicine, † Radiodiagnosis, ‡Histopathology, and §Urology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

出版信息

Clin Nucl Med. 2017 Aug;42(8):e355-e361. doi: 10.1097/RLU.0000000000001689.

DOI:10.1097/RLU.0000000000001689

PMID:28525448

Abstract

PURPOSE

The aim of this study was to compare the diagnostic performance of F-fluorocholine (FCH) PET/CT and dynamic contrast-enhanced MRI (DCE-MRI) of pelvis in restaging prostate cancer (PC) patients with biochemical recurrence (BCR) following radical prostatectomy (RP).

METHODS

Twenty PC patients who had undergone RP and had BCR were recruited in this study. All the patients underwent whole-body FCH PET/CT and DCE-MRI of the pelvis. An overall pattern of recurrent disease was analyzed, and diagnostic accuracy for the detection of pelvic disease recurrence by the 2 modalities was evaluated by taking histopathologic analysis as the criterion standard. The whole-body FCH PET/CT images were also analyzed separately for the presence of any extra lesion(s).

RESULTS

The initial mean Gleason score was 6.3 ± 1.53 (range, 4-9). The mean prostate-specific antigen levels at the time of relapse were 1.9 ± 2.87 ng/mL (range, 0.24-13.2 ng/mL). MRI findings were positive for primary tumor recurrence in the prostate bed in 6 patients (6/20 [30.0%]), pelvic lymph node metastases in 4 patients (4/20 [20.0%]), and for pelvic skeletal metastases in 2 patients (2/20 [10.0%]), respectively. On the other hand, FCH PET/CT results were positive in the corresponding sites in 7 (7/20 [35.0%]), 9 (9/20 [45.0%]), and 2 patients (2/20 [10.0%]), respectively. F-fluorocholine PET/CT and MRI showed comparable results in terms of sensitivity, specificity, and positive and negative predictive values for PC characterization. The whole-body FCH PET/CT was found to be useful in identifying unknown distant metastases in a significant proportion of patients.

CONCLUSIONS

The correlative whole-body FCH PET/CT and pelvic DCE-MRI offer a complementary and comprehensive diagnostic workup for better management of PC patients with BCR following RP.

摘要

目的

本研究旨在比较氟代胆碱（FCH）PET/CT 与动态对比增强 MRI（DCE-MRI）在前列腺癌（PC）根治性前列腺切除术后生化复发（BCR）患者盆腔分期中的诊断性能。

方法

本研究纳入了 20 例接受 RP 且发生 BCR 的 PC 患者。所有患者均行全身 FCH PET/CT 和盆腔 DCE-MRI 检查。分析疾病复发的整体模式，并以组织病理学分析为标准，评估两种方法检测盆腔疾病复发的诊断准确性。还分别分析全身 FCH PET/CT 图像是否存在任何其他病灶。

结果

初始平均 Gleason 评分为 6.3±1.53（范围 4-9）。复发时的平均前列腺特异性抗原水平为 1.9±2.87ng/mL（范围 0.24-13.2ng/mL）。MRI 检查结果显示，前列腺床局部肿瘤复发 6 例（6/20 [30.0%]），盆腔淋巴结转移 4 例（4/20 [20.0%]），骨盆骨转移 2 例（2/20 [10.0%]）。另一方面，FCH PET/CT 结果在相应部位分别为 7 例（7/20 [35.0%]）、9 例（9/20 [45.0%]）和 2 例（2/20 [10.0%]）阳性。F-氟代胆碱 PET/CT 和 MRI 在 PC 特征描述方面的敏感性、特异性、阳性预测值和阴性预测值均相当。全身 FCH PET/CT 发现，在很大一部分患者中，对于识别未知远处转移具有重要作用。