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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
Umeå University, Faculty of Medicine, Department of Radiation Sciences.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
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2014 (English)In: EJNMMI Research, ISSN 2191-219X, E-ISSN 2191-219X, Vol. 4, no 55, 1-9 p.Article in journal (Refereed) Published
Abstract [en]

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). C-11-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 C-11-acetate PET/CT findings and the estimated risk of pelvic lymph node metastases and to assess the impact of C-11-acetate PET/CT on patient management in high-risk prostate cancer patients. Methods: Fifty consecutive prostate cancer patients referred for primary staging with C-11-acetate PET/CT prior to radiotherapy with curative intention were enrolled in this retrospective study. Results: All patients showed increased C-11-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 C-11-acetate PET/CT findings in 43% (20/47) of the patients. Conclusions: The observed proportion of C-11-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 C-11-acetate PET/CT have a considerable impact on patient management.

Place, publisher, year, edition, pages
Springer, 2014. Vol. 4, no 55, 1-9 p.
Keyword [en]
Prostatic neoplasms, PET/CT, C-11-acetate, Neoplasm staging, Lymphatic metastasis
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:umu:diva-106804DOI: 10.1186/s13550-014-0055-1ISI: 000358122600001PubMedID: 26116118OAI: oai:DiVA.org:umu-106804DiVA: diva2:846894
Available from: 2015-08-18 Created: 2015-08-07 Last updated: 2017-12-04Bibliographically approved

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Strandberg, SaraKarlsson, Camilla ThellenbergSundström, TorbjörnÖgren, MattiasÖgren, MargaretaAxelsson, JanRiklund, Katrine
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