| Predictive factors of [(11)C]choline PET/CT in patients with biochemical failure after radical prostatectomy. | |
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MedLine Citation:
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PMID: 19756592 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Detection of recurrence in prostate cancer patients with biochemical failure after radical prostatectomy by [(11)C]choline PET/CT depends on the prostate-specific antigen (PSA) level. The role of other clinical and pathological variables has not been explored. METHODS: A total of 2,124 prostate cancer patients referred to our Institution for [(11)C]choline PET/CT from December 2004 to January 2007 for restaging of disease were retrospectively considered for this study. Inclusion criteria were: previous treatment by radical prostatectomy, and biochemical failure, defined as at least two consecutive PSA measurements of >0.2 ng/ml. These criteria were met for 358 patients. Binary logistic analysis was used to investigate the predictive factors of [(11)C]choline PET/CT. PET/CT findings were validated using criteria based on histological analysis, and follow-up clinical and imaging data. Receiver operating characteristic (ROC) analysis was used to assess the performance of [(11)C]choline PET/CT in relation to PSA levels. RESULTS: The mean PSA level was 3.77 +/- 6.94 ng/ml (range 0.23-45 ng/ml; median 1.27 ng/ml). PET/CT was positive for recurrence in 161 of 358 patients (45%). On an anatomical region basis, [(11)C]choline pathological uptake was observed in lymph nodes (107/161 patients, 66%), prostatectomy bed (55/161 patients, 34%), and in the skeleton (46/161 patients, 29%). PET/CT findings were validated using histological criteria (46/358, 13%), and follow-up clinical and imaging criteria (312/358, 87%). Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were, respectively, 85%, 93%, 91%, 87%, and 89%. In multivariate analysis, high PSA levels, advanced pathological stage, previous biochemical failure and older age were significantly (P < 0.05) associated with an increased risk of positive PET/CT findings. The percentage of positive scans was 19% in those with a PSA level between 0.2 and 1 ng/ml, 46% in those with a PSA level between 1 and 3 ng/ml, and 82% in those with a PSA level higher than 3 ng/ml. ROC analysis showed that PET/CT-positive and PET/CT-negative patients could be best distinguished using a PSA cut-off value of 1.4 ng/ml. CONCLUSIONS: In addition to PSA levels, pathological stage, previous biochemical failure and age should be considered by physicians when referring prostate cancer patients with biochemical failure after radical prostatectomy to [(11)C]choline PET/CT. |
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Authors:
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Giampiero Giovacchini; Maria Picchio; Elisa Coradeschi; Valentino Bettinardi; Luigi Gianolli; Vincenzo Scattoni; Cesare Cozzarini; Nadia Di Muzio; Patrizio Rigatti; Ferruccio Fazio; Cristina Messa |
Publication Detail:
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Type: Journal Article Date: 2009-09-15 |
Journal Detail:
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Title: European journal of nuclear medicine and molecular imaging Volume: 37 ISSN: 1619-7089 ISO Abbreviation: Eur. J. Nucl. Med. Mol. Imaging Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-04 Completed Date: 2010-05-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140988 Medline TA: Eur J Nucl Med Mol Imaging Country: Germany |
Other Details:
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Languages: eng Pagination: 301-9 Citation Subset: IM |
Affiliation:
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Center for Molecular Bioimaging, University of Milano-Bicocca, Milano, Italy. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Choline / analogs & derivatives*, diagnostic use Humans Italy / epidemiology Male Middle Aged Positron-Emission Tomography / utilization* Prevalence Prognosis Prostate-Specific Antigen / blood Prostatectomy / utilization* Prostatic Neoplasms / diagnosis*, epidemiology, surgery* Radiopharmaceuticals / diagnostic use Reproducibility of Results Sensitivity and Specificity Subtraction Technique / utilization Tomography, X-Ray Computed / utilization* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 0/methyl carbon-11 choline; 62-49-7/Choline; EC 3.4.21.77/Prostate-Specific Antigen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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