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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 9/2013

01-09-2013 | Original article

Does 11C-choline PET-CT contribute to multiparametric MRI for prostate cancer localisation?

Authors: L. Van den Bergh, S. Isebaert, M. Koole, R. Oyen, S. Joniau, E. Lerut, C.M. Deroose, F. De Keyzer, H. Van Poppel, K. Haustermans

Published in: Strahlentherapie und Onkologie | Issue 9/2013

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Abstract

Background and purpose

The aim of this work was to determine whether 11C-choline positron emission tomography (PET)–computed tomography (CT) makes a positive contribution to multiparametric magnetic resonance imaging (MRI) for localisation of intraprostatic tumour nodules.

Patients and methods

A total of 73 patients with biopsy-proven intermediate- and high-risk prostate cancer were enrolled in a prospective imaging study consisting of T2-weighted (T2w), dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI and 11C-choline PET-CT before radical prostatectomy. Cancerous regions were delineated on the whole-mount prostatectomy sections and on the different MRI modalities and analysed in 24 segments per patient (3 sections, 8 segments each). To analyse PET-CT images, standardized uptake values (SUV) were calculated per segment.

Results

In total, 1,752 segments were analyzed of which 708 (40.4 %) were found to be malignant. A high specificity (94.7, 93.6 and 92.2 %) but relatively low sensitivity (31.2, 24.9 and 44.1 %) for tumour localisation was obtained with T2w, DCE and DW MRI, respectively. Sensitivity values significantly increased when combining all MRI modalities (57.2 %). For PET-CT, mean SUVmax of malignant octants was significantly higher than mean SUVmax of benign octants (3.68 ± 1.30 vs. 3.12 ± 1.02, p < 0.0001). In terms of accuracy, the benefit of adding PET-CT to (multiparametric) MRI was less than 1 %.

Conclusion

The additional value of 11C-choline PET-CT to MRI in localising intraprostatic tumour nodules is limited, especially when multiparametric MRI is used.
Literature
1.
Mazaheri Y, Shukla-Dave A, Muellner A, Hricak H (2008) MR imaging of the prostate in clinical practice. MAGMA 21:379–392PubMedCrossRef
2.
Wachter S, Wachter-Gerstner N, Bock T et al (2002) Interobserver comparison of CT and MRI-based prostate apex definition. Clinical relevance for conformal radiotherapy treatment planning. Strahlenther Onkol 178:263–268PubMedCrossRef
3.
Turkbey B, Pinto PA, Choyke PL (2009) Imaging techniques for prostate cancer: implications for focal therapy. Nat Rev Urol 6:191–203PubMedCrossRef
4.
Groenendaal G, Berg CA van den, Korporaal JG et al (2010) Simultaneous MRI diffusion and perfusion imaging for tumor delineation in prostate cancer patients. Radiother Oncol 95:185–190PubMedCrossRef
5.
Alonzi R, Padhani AR, Allen C (2007) Dynamic contrast enhanced MRI in prostate cancer. Eur J Radiol 63:335–350PubMedCrossRef
6.
Tan CH, Wang J, Kundra V (2011) Diffusion weighted imaging in prostate cancer. Eur Radiol 21:593–603PubMedCrossRef
7.
Delongchamps NB, Rouanne M, Flam T et al (2011) Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging. BJU Int 107:1411–1418PubMedCrossRef
8.
Langer DL, Kwast TH van der, Evans AJ et al (2009) Prostate cancer detection with multi-parametric MRI: logistic regression analysis of quantitative T2, diffusion-weighted imaging, and dynamic contrast-enhanced MRI. J Magn Reson Imaging 30:327–334PubMedCrossRef
9.
Sciarra A, Barentsz J, Bjartell A et al (2011) Advances in magnetic resonance imaging: how they are changing the management of prostate cancer. Eur Urol 59:962–977PubMedCrossRef
10.
Seitz M, Shukla-Dave A, Bjartell A et al (2009) Functional magnetic resonance imaging in prostate cancer. Eur Urol 55:801–814PubMedCrossRef
11.
Turkbey B, Pinto PA, Mani H et al (2010) Prostate cancer: value of multiparametric MR imaging at 3 T for detection—histopathologic correlation. Radiology 255:89–99PubMedCrossRef
12.
Jadvar H (2011) Prostate cancer: PET with 18F-FDG, 18F- or 11C-acetate, and 18F- or 11C-choline. J Nucl Med 52:81–89PubMedCrossRef
13.
Picchio M, Messa C, Landoni C et al (2003) Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]fluorodeoxyglucose-positron emission tomography. J Urol 169:1337–1340PubMedCrossRef
14.
Grosu AL, Piert M, Weber WA et al (2005) Positron emission tomography for radiation treatment planning. Strahlenther Onkol 181:483–499PubMedCrossRef
15.
Picchio M, Giovannini E, Crivellaro C et al (2010) Clinical evidence on PET/CT for radiation therapy planning in prostate cancer. Radiother Oncol 96:347–350PubMedCrossRef
16.
Pinkawa M, Holy R, Piroth MD et al (2010) Intensity-modulated radiotherapy for prostate cancer implementing molecular imaging with 18F-choline PET-CT to define a simultaneous integrated boost. Strahlenther Onkol 186:600–606PubMedCrossRef
17.
Goldner G, Bombosch V, Geinitz H et al (2009) Moderate risk-adapted dose escalation with three-dimensional conformal radiotherapy of localized prostate cancer from 70 to 74 Gy. First report on 5-year morbidity and biochemical control from a prospective Austrian–German multicenter phase II trial. Strahlenther Onkol 185:94–100PubMedCrossRef
18.
Geier M, Astner ST, Duma MN et al (2012) Dose-escalated simultaneous integrated-boost treatment of prostate cancer patients via helical tomotherapy. Strahlenther Onkol 188:410–416PubMedCrossRef
19.
D’Amico AV, Whittington R, Malkowicz SB et al (2002) Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era. Cancer 95:281–286CrossRef
20.
Hentschel B, Oehler W, Strauss D et al (2011) Definition of the CTV prostate in CT and MRI by using CT-MRI image fusion in IMRT planning for prostate cancer. Strahlenther Onkol 187:183–190PubMedCrossRef
21.
Villeirs GM, Van VK, Vakaet L et al (2005) Interobserver delineation variation using CT versus combined CT + MRI in intensity-modulated radiotherapy for prostate cancer. Strahlenther Onkol 181:424–430PubMedCrossRef
22.
Maes F, Collignon A, Vandermeulen D et al (1997) Multimodality image registration by maximization of mutual information. IEEE Trans Med Imaging 16:187–198PubMedCrossRef
23.
Montironi R, Kwast T van der, Boccon-Gibod L et al (2003) Handling and pathology reporting of radical prostatectomy specimens. Eur Urol 44:626–636PubMedCrossRef
24.
Tamada T, Sone T, Jo Y et al (2008) Prostate cancer: relationships between postbiopsy hemorrhage and tumor detectability at MR diagnosis. Radiology 248:531–539PubMedCrossRef
25.
Chang JH, Joon DL, Lee ST et al (2011) Histopathological correlation of (11)C-choline PET scans for target volume definition in radical prostate radiotherapy. Radiother Oncol 99:187–192PubMedCrossRef
26.
Farsad M, Schiavina R, Castellucci P et al (2005) Detection and localization of prostate cancer: correlation of (11)C-choline PET/CT with histopathologic step-section analysis. J Nucl Med 46:1642–1649PubMed
27.
Giovacchini G, Picchio M, Coradeschi E et al (2008) [(11)C]choline uptake with PET/CT for the initial diagnosis of prostate cancer: relation to PSA levels, tumour stage and anti-androgenic therapy. Eur J Nucl Med Mol Imaging 35:1065–1073PubMedCrossRef
28.
Reske SN, Blumstein NM, Neumaier B et al (2006) Imaging prostate cancer with 11C-choline PET/CT. J Nucl Med 47:1249–1254PubMed
29.
Sutinen E, Nurmi M, Roivainen A et al (2004) Kinetics of [(11)C]choline uptake in prostate cancer: a PET study. Eur J Nucl Med Mol Imaging 31:317–324PubMedCrossRef
30.
Park H, Wood D, Hussain H et al (2012) Introducing parametric fusion PET/MRI of primary prostate cancer. J Nucl Med 53:546–551PubMedCrossRef
31.
Testa C, Schiavina R, Lodi R et al (2007) Prostate cancer: sextant localization with MR imaging, MR spectroscopy, and 11C-choline PET/CT. Radiology 244:797–806PubMedCrossRef
32.
Jambor I, Borra R, Kemppainen J et al (2010) Functional imaging of localized prostate cancer aggressiveness using 11C-acetate PET/CT and 1H-MR spectroscopy. J Nucl Med 51:1676–1683PubMedCrossRef
33.
Yamaguchi T, Lee J, Uemura H et al (2005) Prostate cancer: a comparative study of 11C-choline PET and MR imaging combined with proton MR spectroscopy. Eur J Nucl Med Mol Imaging 32:742–748PubMedCrossRef
34.
Martino P, Scattoni V, Galosi AB et al (2011) Role of imaging and biopsy to assess local recurrence after definitive treatment for prostate carcinoma (surgery, radiotherapy, cryotherapy, HIFU). World J Urol 29:595–605PubMedCrossRef
35.
Panebianco V, Sciarra A, Lisi D et al (2012) Prostate cancer: 1HMRS-DCEMR at 3T versus [(18)F]choline PET/CT in the detection of local prostate cancer recurrence in men with biochemical progression after radical retropubic prostatectomy (RRP). Eur J Radiol 81:700–708PubMedCrossRef
36.
Groenendaal G, Borren A, Moman MR et al (2012) Pathologic validation of a model based on diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging for tumor delineation in the prostate peripheral zone. Int J Radiat Oncol Biol Phys 82:e537–e544PubMedCrossRef
37.
Bundschuh RA, Wendl CM, Weirich G et al (2013) Tumour volume delineation in prostate cancer assessed by [(11)C]choline PET/CT: validation with surgical specimens. Eur J Nucl Med Mol Imaging 40:824–831PubMedCrossRef
38.
Heide UA van der, Houweling AC, Groenendaal G et al (2012) Functional MRI for radiotherapy dose painting. Magn Reson Imaging 30:1216–1223PubMedCrossRef
Metadata
Title
Does 11C-choline PET-CT contribute to multiparametric MRI for prostate cancer localisation?
Authors
L. Van den Bergh
S. Isebaert
M. Koole
R. Oyen
S. Joniau
E. Lerut
C.M. Deroose
F. De Keyzer
H. Van Poppel
K. Haustermans
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 9/2013
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0359-5

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