TY - JOUR
T1 - Prospective comparison of computed tomography, diffusion-weighted magnetic resonance imaging and [11C] choline positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer patients
AU - Heck, Matthias M.
AU - Souvatzoglou, Michael
AU - Retz, Margitta
AU - Nawroth, Roman
AU - Kübler, Hubert
AU - Maurer, Tobias
AU - Thalgott, Mark
AU - Gramer, Bettina M.
AU - Weirich, Gregor
AU - Rondak, Ina Christine
AU - Rummeny, Ernst J.
AU - Schwaiger, Markus
AU - Gschwend, Jürgen E.
AU - Krause, Bernd
AU - Eiber, Matthias
PY - 2014/4
Y1 - 2014/4
N2 - Purpose: The aim of this study was to prospectively compare diffusion-weighted magnetic resonance imaging (DWI) and [11C]choline positron emission tomography/computed tomography (PET/CT) with computed tomography (CT) for preoperative lymph node (LN) staging in prostate cancer (PCa) patients. Methods: Between June 2010 and May 2012, CT, DWI and [ 11C]choline PET/CT were performed preoperatively in 33 intermediate- and high-risk PCa patients undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) including obturator fossa and internal, external and common iliac fields. Patient- and field-based performance characteristics for all three imaging techniques based on histopathological results are reported. Imaging techniques were compared by means of the area under the curve (AUC). Results: LN metastases were detected in 92 of 1,012 (9 %) LNs from 14 of 33 (42 %) patients. On patient-based analysis, sensitivity, specificity and accuracy for CT were 57, 68 and 64 %, respectively, for DWI were 57, 79 and 70 %, respectively, and for [11C]choline PET/CT were 57, 90 and 76 %, respectively. On field-based analysis, these numbers for CT were 47, 94 and 88 %, respectively, for DWI were 56, 97 and 92 %, respectively, and for [11C]choline PET/CT were 62, 96 and 92 %, respectively. Neither DWI nor [11C]choline PET/CT performed significantly better than CT on pairwise comparison of patient- and field-based results. Conclusion: All three imaging techniques exhibit a rather low sensitivity with less than two thirds of LN metastases being detected on patient- and field-based analysis. Overall diagnostic efficacy did not differ significantly between imaging techniques, whereas distinct performance characteristics, esp. patient-based specificity, were best for [11C]choline PET/CT followed by DWI and CT.
AB - Purpose: The aim of this study was to prospectively compare diffusion-weighted magnetic resonance imaging (DWI) and [11C]choline positron emission tomography/computed tomography (PET/CT) with computed tomography (CT) for preoperative lymph node (LN) staging in prostate cancer (PCa) patients. Methods: Between June 2010 and May 2012, CT, DWI and [ 11C]choline PET/CT were performed preoperatively in 33 intermediate- and high-risk PCa patients undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) including obturator fossa and internal, external and common iliac fields. Patient- and field-based performance characteristics for all three imaging techniques based on histopathological results are reported. Imaging techniques were compared by means of the area under the curve (AUC). Results: LN metastases were detected in 92 of 1,012 (9 %) LNs from 14 of 33 (42 %) patients. On patient-based analysis, sensitivity, specificity and accuracy for CT were 57, 68 and 64 %, respectively, for DWI were 57, 79 and 70 %, respectively, and for [11C]choline PET/CT were 57, 90 and 76 %, respectively. On field-based analysis, these numbers for CT were 47, 94 and 88 %, respectively, for DWI were 56, 97 and 92 %, respectively, and for [11C]choline PET/CT were 62, 96 and 92 %, respectively. Neither DWI nor [11C]choline PET/CT performed significantly better than CT on pairwise comparison of patient- and field-based results. Conclusion: All three imaging techniques exhibit a rather low sensitivity with less than two thirds of LN metastases being detected on patient- and field-based analysis. Overall diagnostic efficacy did not differ significantly between imaging techniques, whereas distinct performance characteristics, esp. patient-based specificity, were best for [11C]choline PET/CT followed by DWI and CT.
KW - Computed tomography
KW - Diffusion-weighted magnetic resonance imaging
KW - Extended pelvic lymph node dissection
KW - Lymph node metastasis
KW - Positron emission tomography
KW - Prostate cancer
KW - Radical prostatectomy
KW - Staging
UR - http://www.scopus.com/inward/record.url?scp=84897025545&partnerID=8YFLogxK
U2 - 10.1007/s00259-013-2634-1
DO - 10.1007/s00259-013-2634-1
M3 - Article
C2 - 24297503
AN - SCOPUS:84897025545
SN - 1619-7070
VL - 41
SP - 694
EP - 701
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 4
ER -