Preoperative lymph node staging in patients with primary prostate cancer: Comparison and correlation of quantitative imaging parameters in diffusion-weighted imaging and 11C-choline PET/CT

Tibor Vag, Matthias M. Heck, Ambros J. Beer, Michael Souvatzoglou, Gregor Weirich, Konstantin Holzapfel, Bernd Joachim Krause, Markus Schwaiger, Matthias Eiber, Ernst J. Rummeny

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Purpose: To compare the diagnostic performance of DWI and 11C-choline PET/CT in the assessment of preoperative lymph node status in patients with primary prostate cancer. Material and methods: Thirty-three patients underwent DWI and 11C-choline PET/CT prior to prostatectomy and extended pelvic lymph node dissection. Mean standardised uptake value (SUV mean ) and mean apparent diffusion coefficient (ADC) of 76 identified lymph nodes (LN) were measured and correlated with histopathology. ADC values and SUVs were compared using linear regression analysis. Results: A significant difference between benign and malignant LN was observed for ADC values (1.17 vs. 0.96 × 10 -3 mm 2 /s; P < 0.001) and SUV mean (1.61 vs. 3.20; P < 0.001). ROC analysis revealed an optimal ADC threshold of 1.01 × 10 -3 mm 2 /s for differentiating benign from malignant LN with corresponding sensitivity/specificity of 69.70 %/78.57 % and an area under the curve (AUC) of 0.785. The optimal threshold for SUV mean was 2.5 with corresponding sensitivity/specificity of 69.72 %/90.48 % and with an AUC of 0.832. ADC values and SUV mean showed a moderate significant inverse correlation (r = -0.63). Conclusion: Both modalities reveal similar moderate diagnostic performance for preoperative lymph node staging of prostate cancer, not justifying their application in routine clinical practice at this time. The only moderate inverse correlation between ADC values and SUV mean suggests that both imaging parameters might provide complementary information on tumour biology. • Conventional imaging shows low performance for lymph node staging in prostate cancer. • DWI and 11C-choline PET/CT both provide additional functional information • Both functional modalities reveal only moderate diagnostic performance.

Original languageEnglish
Pages (from-to)1821-1826
Number of pages6
JournalEuropean Radiology
Volume24
Issue number8
DOIs
StatePublished - Aug 2014
Externally publishedYes

Keywords

  • Choline PET/CT
  • DWI
  • Lymph node staging
  • Prostate carcinoma
  • Semiquantitative parameters

Fingerprint

Dive into the research topics of 'Preoperative lymph node staging in patients with primary prostate cancer: Comparison and correlation of quantitative imaging parameters in diffusion-weighted imaging and 11C-choline PET/CT'. Together they form a unique fingerprint.

Cite this