Prospective Comparison of F-18 Choline PET/CT Scan Versus Axial MRI for Detecting Bone Metastasis in Biochemically Relapsed Prostate Cancer Patients
Wouter Huysse,
Frédéric Lecouvet,
Paolo Castellucci,
Piet Ost,
Valerie Lambrecht,
Carlos Artigas,
Marie-Laurence Denis,
Kathia De Man,
Louke Delrue,
Lennart Jans,
Aurélie De Bruycker,
Filip De Vos,
Gert De Meerleer,
Karel Decaestecker,
Valerie Fonteyne,
Bieke Lambert
Affiliations
Wouter Huysse
Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
Frédéric Lecouvet
Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10/2942, B-1200 Brussels, Belgium
Paolo Castellucci
Service of Nuclear Medicine, Policlinico Sant’Orsola-Malpighi, University of Bologna, 40126 Bologna, Italy
Piet Ost
Department of Radiation Oncology and Experimental Cancer Research, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
Valerie Lambrecht
Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10/2942, B-1200 Brussels, Belgium
Kathia De Man
Department of Nuclear Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
Louke Delrue
Laboratory of Radiopharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
Lennart Jans
Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
Aurélie De Bruycker
Department of Radiation Oncology and Experimental Cancer Research, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
Filip De Vos
Radiology and Nuclear Medicine, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
Gert De Meerleer
Department of Radiation Oncology and Experimental Cancer Research, UZ Leuven, Herestraat 49, 3000 Leuven, Belgium
Karel Decaestecker
Department of Urology and Experimental Cancer Research, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
Valerie Fonteyne
Department of Radiation Oncology and Experimental Cancer Research, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
Bieke Lambert
Radiology and Nuclear Medicine, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
We compared fluor-18 choline positron emission tomography/computed tomography (PET/CT) and axial skeleton magnetic resonance imaging (MRI) prospectively obtained for the detection of bone metastases in non-castrated patients with biochemically recurrent prostate cancer following primary treatment. PET/CT was performed 45 min post-injection of 3–4 MBq/kg F-18 methyl choline. MRI included T1- and fluid sensitive T2-weighted images of the spine and pelvis. Readers were initially blinded from other results and all scans underwent independent double reading. The best valuable comparator (BVC) defined the metastatic status. On the basis of the BVC, 15 out of 64 patients presented with 24 bone metastases. On a patient level, the sensitivity and specificity of MRI and PET were not significantly different. On a lesion level, the sensitivity of MRI was significantly better compared to PET, and the specificity did not differ significantly. In conclusion, axial MRI is an interesting screening tool for the detection of bone metastases because of its low probability of false negative results. However, F-18 choline PET is a valuable addition as it can overrule false positive MRI results and detect non-axial metastases.
