| 11C-choline positron emission tomography/computerized tomography for preoperative lymph-node staging in intermediate-risk and high-risk prostate cancer: comparison with clinical staging nomograms. | |
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MedLine Citation:
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PMID: 18456393 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Conventional imaging (CI) techniques are inadequate for lymph node (LN) staging in prostate cancer (PCa). OBJECTIVES: To assess the accuracy of (11)C-Choline positron emission tomography/computerized tomography (PET/CT) for LN staging in intermediate-risk and high-risk PCa and to compare it with two currently used nomograms. DESIGN, SETTING, AND PARTICIPANTS: From January 2007 to September 2007, 57 PCa patients at intermediate risk (n=27) or high risk (n=30) were enrolled at two academic centres. All patients underwent preoperative PET/CT and radical prostatectomy with extended pelvic LN dissection (PLND). Risk of LN metastasis (LNM) was assessed using available nomograms. MEASUREMENTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and number of correctly recognized cases for LNM detection at PET/CT were assessed. The accuracy of PET/CT for LNM detection was compared with the accuracy of nomograms for LNM prediction by using receiver operating characteristic (ROC) analysis. RESULTS AND LIMITATIONS: Fifteen patients (26%) had LNMs, and a total of 41 LNMs were identified. On a patient analysis, sensitivity, specificity, PPV, NPV, and number of correctly recognized cases at PET/CT were 60.0%, 97.6%, 90.0%, 87.2%, and 87.7% while, on node analysis, these numbers were 41.4%, 99.8%, 94.4%, 97.2%, and 97.1%. The mean diameter (in mm) of the metastatic deposit of true-positive LNs was significantly higher than that of false-negative LNs (9.2 vs 4.2; p=0.001). PET/CT showed higher specificity and accuracy than the nomograms; however, in pairwise comparison, the areas under the curve (AUCs) were not statistically different (all p values >0.05). CONCLUSIONS: In patients with intermediate-risk and high-risk PCa, (11)C-Choline PET/CT has quite a low sensitivity for LNM detection but performed better than clinical nomograms, with equal sensitivity and better specificity. |
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Authors:
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Riccardo Schiavina; Vincenzo Scattoni; Paolo Castellucci; Maria Picchio; Barbara Corti; Alberto Briganti; Alessandro Franceschelli; Francesco Sanguedolce; Alessandro Bertaccini; Moshen Farsad; Giampiero Giovacchini; Stefano Fanti; Walter Franco Grigioni; Ferruccio Fazio; Francesco Montorsi; Patrizio Rigatti; Giuseppe Martorana |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-04-18 |
Journal Detail:
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Title: European urology Volume: 54 ISSN: 1873-7560 ISO Abbreviation: Eur. Urol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-01 Completed Date: 2009-06-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7512719 Medline TA: Eur Urol Country: Switzerland |
Other Details:
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Languages: eng Pagination: 392-401 Citation Subset: IM |
Affiliation:
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Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carbon Radioisotopes / diagnostic use* Choline / diagnostic use* Humans Lymphatic Metastasis Male Middle Aged Neoplasm Staging Nomograms* Positron-Emission Tomography* Preoperative Care Prostatic Neoplasms / pathology*, radionuclide imaging*, surgery Reproducibility of Results Risk Assessment Tomography, X-Ray Computed* |
| Chemical | |
Reg. No./Substance:
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0/Carbon Radioisotopes; 62-49-7/Choline |
| Comments/Corrections | |
Comment In:
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Eur Urol. 2008 Aug;54(2):400-1
[PMID:
18456392
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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