Abstract
BackgroundTo assess whether whole-body (WB) bone SPECT/CT provides additional diagnostic information over [18F]-FCH PET/CT for the detection of bone metastases in the setting of prostate cancer biochemical recurrence (PC-BR).MethodsPatients referred for a PC-BR and whom benefited from a WB bone SPECT/CT and FCH PET/CT were retrospectively included. Tests were classified as positive, equivocal, or negative for bone metastases. A best valuable comparator (BVC) strategy including imaging and follow-up data was used to determine the metastatic status in the absence of systematic histological evaluation.ResultsBetween January 2011 and November 2017, 115 consecutive patients with a PC-BR were evaluated. According to the BVC, 30 patients had bone metastases and 85 patients did not present with bone lesions. The sensitivity, specificity, positive and negative predictive values were respectively 86.7% [69.3–96.2], 98.8% [93.6–100.0], 96.3% [78.7–99.5], and 95.5% [89.4–98.1] for WB bone SPECT/CT and 93.3% [77.9–99.2], 100.0% [95.8–100.0], 100.0 and 97.7% [91.8–99.4] for FCH PET/CT. There was no significant difference in diagnostic accuracy of bone metastases between WB Bone SPECT/CT (AUC 0.824 [0.74–0.90]) and FCH PET/CT (AUC 0.829 [0.75–0.90], p = 0.41).ConclusionDespite good performances for the diagnosis of bone metastases in PC-BR, WB bone SPECT/CT does not provide additive diagnostic information over concomitant FCH PET/CT.
Highlights
Prostate cancer (PC) is the most common form of male cancer in Europe, representing about 400,000 new cases / year in Europe [1, 2] and the third leading cause of death in men over 50 years – old [3]
From January 2011 to November 2017, 115 patients were evaluated by both WB bone SPECT/CT and FCH Positron emission tomography (PET)/CT for a biochemical recurrence of PC
There were 13 patients whom were treated by radical prostatectomy (RP) only (11.3%), 50 patients were treated by external beam radiotherapy (EBRT) only (43.5%), and 34 whom were treated by RP and EBRT (29.6%)
Summary
Prostate cancer (PC) is the most common form of male cancer in Europe, representing about 400,000 new cases / year in Europe [1, 2] and the third leading cause of death in men over 50 years – old [3]. After initial postdiagnostic radical treatments, follow-up is performed through physical examination and blood prostate specific antigen (PSA) assessment [4]. Biochemical recurrence (BR) occurs in 20– 50% of patients within 10 years following local treatment [5]. While PSA is a very sensitive tool to detect relapse, it is not suitable for the characterization of disease extension [7]. For patients presenting with biochemical recurrence, determining whether the disease is locally confined or systemically spread is of paramount importance for the selection of the most appropriate therapeutic strategy between local salvage treatment or systemic treatment. To assess whether whole-body (WB) bone SPECT/CT provides additional diagnostic information over [18F]-FCH PET/CT for the detection of bone metastases in the setting of prostate cancer biochemical recurrence (PC-BR)
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