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World J Urol. 2018 Oct 31. doi: 10.1007/s00345-018-2547-5. [Epub ahead of print]

Impact of sodium 18F-fluoride PET/CT, 18F-fluorocholine PET/CT and whole-body diffusion-weighted MRI on the management of patients with prostate cancer suspicious for metastasis: a prospective multicentre study.

Author information

1
Department of Nuclear Medicine, Hôpital Tenon, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, 4 rue de la Chine, 75020, Paris, France. mathieugauthe@yahoo.fr.
2
AP-HP Health Economics Research Unit, INSERM UMR 1123, Paris, France. mathieugauthe@yahoo.fr.
3
Department of Nuclear Medicine, Hôpital Tenon, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.
4
Department of Radiology, Centre du Cancer, Institut de Recherche Expérimentale Et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
5
Nuclear Medicine Unit, ICO Gauducheau Cancer Centre, Saint-Herblain, France.
6
Nantes-Angers Cancer Research Centre, INSERM U892, CNRS UMR 6299, Université de Nantes, Nantes, France.
7
Department of Radiology, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France.
8
Department of Urology, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France.
9
GRC No 5, ONCOTYPE-URO, Institut Universitaire de Cancérologie, Sorbonne Université, Paris, France.
10
AP-HP Health Economics Research Unit, INSERM UMR 1123, Paris, France.
11
Service de Santé Publique, Hôpital Henri Mondor, AP-HP, Université Paris 12, Créteil, France.

Abstract

PURPOSE:

To compare the impact of 18F-sodium-fluoride (NaF) PET/CT, 18F-fluorocholine (FCH) PET/CT and diffusion-weighted whole-body MRI (DW-MRI) on the management of patients with prostate cancer (PCa) suspicious for distant metastasis.

METHODS:

Prostate cancer patients were prospectively included between December 2011 and August 2014 and benefited from these three whole-body imaging (WBI) modalities within 1 month in addition to the standard PCa workup. Management was prospectively decided by clinicians during two multidisciplinary meetings, before and after the whole-body imaging workup. Rates of induced changes of whole-body imaging modalities were compared by Cochran's Q test.

RESULTS:

One-hundred-one patients (27 at staging, 59 at first biochemical recurrence (BCR) and 15 at first episode of rising serum level of prostate-specific antigen during androgen-deprivation therapy) were included. The overall rate of management changes was 52%: 29% as a consequence of WBI, higher for FCH-PET/CT than for NaF-PET/CT or DW-MRI (p < 0.0001) and highest (41%) for FCH-PET/CT at BCR. Actual management was adequate in all patients but two.

CONCLUSIONS:

Whole-body imaging induced a change in management in approximately a third of PCa patients suspicious for metastasis. The impact rate was determined to be greatest at first BCR using FCH-PET/CT. NaF-PET/CT and DW-MRI seemed less useful in this context.

KEYWORDS:

DW-MRI; Impact on management; PET/CT; Progression-free survival; Prostate cancer imaging

PMID:
30382380
DOI:
10.1007/s00345-018-2547-5

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