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Open Access 01-12-2023 | Computed Tomography | Original Article

Whole-body low-dose CT can be of value in prostate cancer decision-making: a retrospective study on 601 patients

Authors: Mohammadreza Chavoshi, Seyed Ali Mirshahvalad, Sara Zamani, Amir Reza Radmard, Babak Fallahi, Seyed Asadollah Mousavi

Published in: Insights into Imaging | Issue 1/2023

Abstract

Objectives

To evaluate the diagnostic value of whole-body low-dose computed tomography (CT) to detect bone metastasis in prostate cancer (PCa) patients and its possible utility in therapeutic decision-making. Also, to determine the valuable CT features for lesion characterisation.

Methods

This IRB-approved retrospective study reviewed PCa patients who underwent ⁶⁸Ga-PSMA PET/CT in our centre from March 2017 to August 2022. Two board-certified radiologists and one nuclear medicine specialist reported all whole-body low-dose CT scans separately, unaware of the ⁶⁸Ga-PSMA-PET results. The per-lesion and per-patient diagnostic performances were calculated. Also, the significance of CT features was evaluated. Moreover, the inter-observer agreement was analysed. A two-tailed p value < 0.05 was considered significant.

Results

From 727 reviewed PCa patients, 601 (mean age = 68.7 ± 8.1) were found to be eligible, including 211 (35.1%) referrals for initial staging and 390 (64.9%) for evaluating the extent of the disease after biochemical recurrence. Per-patient diagnostic analysis for three reviewers showed 81.0–89.4% sensitivity and 96.6–98.5% specificity in detecting osteo-metastasis. It was able to correctly detect high-burden disease based on both CHAARTED and LATITUDE criteria. Regarding the value of underlying CT features, size > 1 cm, ill-defined borders, presence of soft-tissue component, and cortical destruction were statistically in favour of metastasis. Also, Hu > 900 was in favour of benign entities with 93% specificity.

Conclusions

Although not as accurate as ⁶⁸Ga-PSMA PET/CT, whole-body low-dose CT might precisely classify PCa patients considering therapeutic decision-making. Additionally, we proposed diagnostic CT features that could help radiologists with better characterisation of the detected lesions.

Critical relevance statement

The whole-body low-dose CT can be considered valuable in the clinical decision-making of prostate cancer patients. This modality may obviate performing multiple imaging sessions and high-cost scans in patients diagnosed with the high-burden disease.

Graphical abstract

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Title: Whole-body low-dose CT can be of value in prostate cancer decision-making: a retrospective study on 601 patients
Authors: Mohammadreza Chavoshi
Seyed Ali Mirshahvalad
Sara Zamani
Amir Reza Radmard
Babak Fallahi
Seyed Asadollah Mousavi
Publication date: 01-12-2023
Publisher: Springer Vienna
Keywords: Computed Tomography
Computed Tomography
Metastasis
Prostate Cancer
Prostate Cancer
Positron Emission Tomography
Published in: Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-023-01475-w

2024 ASCO Annual Meeting

Springer Medicine

Whole-body low-dose CT can be of value in prostate cancer decision-making: a retrospective study on 601 patients

Abstract

Objectives

Methods

Results

Conclusions

Critical relevance statement

Graphical abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Critical relevance statement

Graphical abstract

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