18F-fluorocholine PET whole-body MRI in the staging of high-risk prostate cancer

Ur Metser, Alejandro Berlin, Jaydeep Halankar, Grainne Murphy, Kartik S. Jhaveri, Sangeet Ghai, Noam Tau

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE. The purpose of this study was to determine whether integrated 18F-fluoro-choline (FCH) PET whole-body MRI (PET/WBMRI) depicts lymph node and distant metastases in patients with high-risk prostate cancer more frequently than does conventional staging. SUBJECTS AND METHODS. A prospective study included 58 patients with untreated high-risk prostate cancer. After conventional staging (CT and bone scintigraphy), patients underwent FCH PET/WBMRI (n = 10) or FCH PET/CT and WBMRI (n = 48). Metastatic sites and disease stage were recorded for each modality (conventional imaging, PET, WBMRI, and PET/WBMRI) and compared with a standard of reference (histopathologic examination, imaging, and clinical follow-up) and early clinical outcomes. RESULTS. In the detection of metastases, PET had significantly higher sensitivity (72/77 [93.5%]) than conventional imaging (49/77 [63.6%]; p < 0.001) and WBMRI (56/77 [72.7%]; p = 0.002). There was a trend toward improved detection with PET/WBMRI (77/77 [100%]) compared with PET alone (p = 0.059). For correct NM staging, PET and PET/WBMRI performed better than conventional imaging (p = 0.002) and WBMRI (p = 0.008). Twelve of 56 patients (21.4%) had early biochemical failure after radical treatment (median, 7 months; range, 1-20 months). This rate was higher for patients with M1a or M1b disease at PET/ WBMRI than for others, but this finding did not reach statistical significance (4/8 [50%] vs 8/48 [16.7%]; p = 0.055). CONCLUSION. In patients with high-risk prostate cancer, FCH PET and FCH PET/ WBMRI depict significantly more metastatic lesions than do conventional imaging and WBMRI. Stage determined with PET/WBMRI may correlate with early outcomes.

LanguageEnglish (US)
Pages635-640
Number of pages6
JournalAmerican Journal of Roentgenology
Volume210
Issue number3
DOIs
StatePublished - Mar 1 2018

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Prostatic Neoplasms
Choline
Neoplasm Metastasis
Radionuclide Imaging
fluorocholine
Lymph Nodes
Prospective Studies
Bone and Bones
Therapeutics

Keywords

  • Fluorocholine
  • PET
  • Prostate cancer
  • Staging
  • Whole-body MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

18F-fluorocholine PET whole-body MRI in the staging of high-risk prostate cancer. / Metser, Ur; Berlin, Alejandro; Halankar, Jaydeep; Murphy, Grainne; Jhaveri, Kartik S.; Ghai, Sangeet; Tau, Noam.

In: American Journal of Roentgenology, Vol. 210, No. 3, 01.03.2018, p. 635-640.

Research output: Contribution to journalArticle

Metser, Ur ; Berlin, Alejandro ; Halankar, Jaydeep ; Murphy, Grainne ; Jhaveri, Kartik S. ; Ghai, Sangeet ; Tau, Noam. / 18F-fluorocholine PET whole-body MRI in the staging of high-risk prostate cancer. In: American Journal of Roentgenology. 2018 ; Vol. 210, No. 3. pp. 635-640.
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abstract = "OBJECTIVE. The purpose of this study was to determine whether integrated 18F-fluoro-choline (FCH) PET whole-body MRI (PET/WBMRI) depicts lymph node and distant metastases in patients with high-risk prostate cancer more frequently than does conventional staging. SUBJECTS AND METHODS. A prospective study included 58 patients with untreated high-risk prostate cancer. After conventional staging (CT and bone scintigraphy), patients underwent FCH PET/WBMRI (n = 10) or FCH PET/CT and WBMRI (n = 48). Metastatic sites and disease stage were recorded for each modality (conventional imaging, PET, WBMRI, and PET/WBMRI) and compared with a standard of reference (histopathologic examination, imaging, and clinical follow-up) and early clinical outcomes. RESULTS. In the detection of metastases, PET had significantly higher sensitivity (72/77 [93.5{\%}]) than conventional imaging (49/77 [63.6{\%}]; p < 0.001) and WBMRI (56/77 [72.7{\%}]; p = 0.002). There was a trend toward improved detection with PET/WBMRI (77/77 [100{\%}]) compared with PET alone (p = 0.059). For correct NM staging, PET and PET/WBMRI performed better than conventional imaging (p = 0.002) and WBMRI (p = 0.008). Twelve of 56 patients (21.4{\%}) had early biochemical failure after radical treatment (median, 7 months; range, 1-20 months). This rate was higher for patients with M1a or M1b disease at PET/ WBMRI than for others, but this finding did not reach statistical significance (4/8 [50{\%}] vs 8/48 [16.7{\%}]; p = 0.055). CONCLUSION. In patients with high-risk prostate cancer, FCH PET and FCH PET/ WBMRI depict significantly more metastatic lesions than do conventional imaging and WBMRI. Stage determined with PET/WBMRI may correlate with early outcomes.",
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T1 - 18F-fluorocholine PET whole-body MRI in the staging of high-risk prostate cancer

AU - Metser, Ur

AU - Berlin, Alejandro

AU - Halankar, Jaydeep

AU - Murphy, Grainne

AU - Jhaveri, Kartik S.

AU - Ghai, Sangeet

AU - Tau, Noam

PY - 2018/3/1

Y1 - 2018/3/1

N2 - OBJECTIVE. The purpose of this study was to determine whether integrated 18F-fluoro-choline (FCH) PET whole-body MRI (PET/WBMRI) depicts lymph node and distant metastases in patients with high-risk prostate cancer more frequently than does conventional staging. SUBJECTS AND METHODS. A prospective study included 58 patients with untreated high-risk prostate cancer. After conventional staging (CT and bone scintigraphy), patients underwent FCH PET/WBMRI (n = 10) or FCH PET/CT and WBMRI (n = 48). Metastatic sites and disease stage were recorded for each modality (conventional imaging, PET, WBMRI, and PET/WBMRI) and compared with a standard of reference (histopathologic examination, imaging, and clinical follow-up) and early clinical outcomes. RESULTS. In the detection of metastases, PET had significantly higher sensitivity (72/77 [93.5%]) than conventional imaging (49/77 [63.6%]; p < 0.001) and WBMRI (56/77 [72.7%]; p = 0.002). There was a trend toward improved detection with PET/WBMRI (77/77 [100%]) compared with PET alone (p = 0.059). For correct NM staging, PET and PET/WBMRI performed better than conventional imaging (p = 0.002) and WBMRI (p = 0.008). Twelve of 56 patients (21.4%) had early biochemical failure after radical treatment (median, 7 months; range, 1-20 months). This rate was higher for patients with M1a or M1b disease at PET/ WBMRI than for others, but this finding did not reach statistical significance (4/8 [50%] vs 8/48 [16.7%]; p = 0.055). CONCLUSION. In patients with high-risk prostate cancer, FCH PET and FCH PET/ WBMRI depict significantly more metastatic lesions than do conventional imaging and WBMRI. Stage determined with PET/WBMRI may correlate with early outcomes.

AB - OBJECTIVE. The purpose of this study was to determine whether integrated 18F-fluoro-choline (FCH) PET whole-body MRI (PET/WBMRI) depicts lymph node and distant metastases in patients with high-risk prostate cancer more frequently than does conventional staging. SUBJECTS AND METHODS. A prospective study included 58 patients with untreated high-risk prostate cancer. After conventional staging (CT and bone scintigraphy), patients underwent FCH PET/WBMRI (n = 10) or FCH PET/CT and WBMRI (n = 48). Metastatic sites and disease stage were recorded for each modality (conventional imaging, PET, WBMRI, and PET/WBMRI) and compared with a standard of reference (histopathologic examination, imaging, and clinical follow-up) and early clinical outcomes. RESULTS. In the detection of metastases, PET had significantly higher sensitivity (72/77 [93.5%]) than conventional imaging (49/77 [63.6%]; p < 0.001) and WBMRI (56/77 [72.7%]; p = 0.002). There was a trend toward improved detection with PET/WBMRI (77/77 [100%]) compared with PET alone (p = 0.059). For correct NM staging, PET and PET/WBMRI performed better than conventional imaging (p = 0.002) and WBMRI (p = 0.008). Twelve of 56 patients (21.4%) had early biochemical failure after radical treatment (median, 7 months; range, 1-20 months). This rate was higher for patients with M1a or M1b disease at PET/ WBMRI than for others, but this finding did not reach statistical significance (4/8 [50%] vs 8/48 [16.7%]; p = 0.055). CONCLUSION. In patients with high-risk prostate cancer, FCH PET and FCH PET/ WBMRI depict significantly more metastatic lesions than do conventional imaging and WBMRI. Stage determined with PET/WBMRI may correlate with early outcomes.

KW - Fluorocholine

KW - PET

KW - Prostate cancer

KW - Staging

KW - Whole-body MRI

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