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EJNMMI Research
Published in: EJNMMI Research 1/2014

Open Access 01-12-2014 | Original research

11C-acetate PET/CT in pre-therapeutic lymph node staging in high-risk prostate cancer patients and its influence on disease management - a retrospective study

Authors: Sara Strandberg, Camilla Thellenberg Karlsson, Torbjörn Sundström, Mattias Ögren, Margareta Ögren, Jan Axelsson, Katrine Riklund

Published in: EJNMMI Research | Issue 1/2014

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Abstract

Background

Radiation treatment with simultaneous integrated boost against suspected lymph node metastases may be a curative therapeutic option in patients with high-risk prostate cancer (>15% estimated risk of pelvic lymph node metastases according to the Cagiannos nomogram). 11C-acetate positron emission tomography/computed tomography (PET/CT) can be used for primary staging as well as for detection of suspected relapse of prostate cancer. The aims of this study were to evaluate the association between positive 11C-acetate PET/CT findings and the estimated risk of pelvic lymph node metastases and to assess the impact of 11C-acetate PET/CT on patient management in high-risk prostate cancer patients.

Methods

Fifty consecutive prostate cancer patients referred for primary staging with 11C-acetate PET/CT prior to radiotherapy with curative intention were enrolled in this retrospective study.

Results

All patients showed increased 11C-acetate uptake in the prostate. Pelvic lymph node uptake was seen in 42% (21/50) of the patients, with positive external iliac lymph nodes in 71% (15/21) of these. The overall observed proportion of PET/CT-positive pelvic lymph nodes at patient level was higher than the average estimated risk, especially in low-risk groups (<15%). There was a significant association between observed proportion and estimated risk of pelvic lymph node metastases in groups with ≤45 and >45% estimated risk. Treatment strategy was altered due to 11C-acetate PET/CT findings in 43% (20/47) of the patients.

Conclusions

The observed proportion of 11C-acetate PET/CT findings suggestive of locoregional metastases was higher than the estimated risk, suggesting that the Cagiannos nomogram underestimates the risk for metastases. The imaging results with 11C-acetate PET/CT have a considerable impact on patient management.
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Metadata
Title
11C-acetate PET/CT in pre-therapeutic lymph node staging in high-risk prostate cancer patients and its influence on disease management - a retrospective study
Authors
Sara Strandberg
Camilla Thellenberg Karlsson
Torbjörn Sundström
Mattias Ögren
Margareta Ögren
Jan Axelsson
Katrine Riklund
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
EJNMMI Research / Issue 1/2014
Electronic ISSN: 2191-219X
DOI
https://doi.org/10.1186/s13550-014-0055-1

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