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European Radiology
Published in: European Radiology 8/2014

01-08-2014 | Urogenital

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

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

Published in: European Radiology | Issue 8/2014

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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 (SUVmean) 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 mm2/s; P < 0.001) and SUVmean (1.61 vs. 3.20; P < 0.001). ROC analysis revealed an optimal ADC threshold of 1.01 × 10-3 mm2/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 SUVmean was 2.5 with corresponding sensitivity/specificity of 69.72 %/90.48 % and with an AUC of 0.832. ADC values and SUVmean 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 SUVmean suggests that both imaging parameters might provide complementary information on tumour biology.

Key Points

• 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.
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Metadata
Title
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
Authors
Tibor Vag
Matthias M. Heck
Ambros J. Beer
Michael Souvatzoglou
Gregor Weirich
Konstantin Holzapfel
Bernd Joachim Krause
Markus Schwaiger
Matthias Eiber
Ernst J. Rummeny
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3240-8

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Erratum to: 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

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