Percutaneous Image-Guided Nodal Biopsy After 11C-Choline PET/CT for Biochemically Recurrent Prostate Cancer: Imaging Predictors of Disease and Clinical Implications

Abstract Purpose Management of recurrent prostate cancer necessitates timely diagnosis and accurate localization of the sites of recurrent disease. The purpose of this study was to assess predictors of histologic outcomes after 11C-choline positron emission tomography/computed tomography (CholPET) t...

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Published in:Advances in radiation oncology 2019-01, Vol.4 (1), p.79-89
Main Authors: Welch, Brian T., MD, Packard, Ann T., MD, Atwell, Thomas D., MD, Johnson, Geoffrey B., MD, PhD, Lowe, Val J., MD, Karnes, Robert Jeffrey, MD, Mynderse, Lance A., MD, Gunderson, Tina M., MS, Park, Sean S., MD, Stish, Bradley J., MD, Evans, Jaden D., MD, Kwon, Eugene D., MD, Davis, Brian J., MD, PhD, Nathan, Mark A., MD
Format: Article
Language:English
Subjects:
Genitourinary Cancer
Hematology, Oncology, and Palliative Medicine
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Summary:Abstract Purpose Management of recurrent prostate cancer necessitates timely diagnosis and accurate localization of the sites of recurrent disease. The purpose of this study was to assess predictors of histologic outcomes after 11C-choline positron emission tomography/computed tomography (CholPET) to increase the positive predictive value and specificity of CholPET in identifying imaging predictors of malignant and benign nodal disease to better inform clinical decision making regarding local therapy planning. Materials and Methods Retrospective review of patients undergoing CholPET followed by percutaneous core needle biopsy between January 1, 2010 and January 1, 2016. A total of 153 patients were identified who underwent 166 biopsy procedures. Patient, CholPET, procedural, and pathologic characteristics were recorded. Results A total of 157 biopsies were technically successful, and 110 (70.1%; 95% confidence interval, 62.2-77.1) yielded histologic results abnormal for metastatic prostate cancer. Lesion location, lesion maximum standardized uptake value (SUVmax), SUV ratio (calculated as the ratio of SUVmax to SUV mean in the right atrium), prostate-specific antigen, lesion short axis length, total Gleason score, and castration resistance were all associated with abnormal biopsy results ( P values
ISSN:2452-1094
2452-1094
DOI:10.1016/j.adro.2018.08.022