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Miyahira AK, Hawley JE, Adelaiye-Ogala R, Calais J, Nappi L, Parikh R, Seibert TM, Wasmuth EV, Wei XX, Pienta KJ, Soule HR. Exploring new frontiers in prostate cancer research: Report from the 2022 Coffey-Holden prostate cancer academy meeting. Prostate 2023; 83:207-226. [PMID: 36443902 DOI: 10.1002/pros.24461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION The 2022 Coffey-Holden Prostate Cancer Academy (CHPCA) Meeting, "Exploring New Frontiers in Prostate Cancer Research," was held from June 23 to 26, 2022, at the University of California, Los Angeles, Luskin Conference Center, in Los Angeles, CA. METHODS The CHPCA Meeting is an annual discussion-oriented scientific conference organized by the Prostate Cancer Foundation, that focuses on emerging and next-step topics deemed critical for making the next major advances in prostate cancer research and clinical care. The 2022 CHPCA Meeting included 35 talks over 10 sessions and was attended by 73 academic investigators. RESULTS Major topic areas discussed at the meeting included: prostate cancer diversity and disparities, the impact of social determinants on research and patient outcomes, leveraging real-world and retrospective data, development of artificial intelligence biomarkers, androgen receptor (AR) signaling biology and new strategies for targeting AR, features of homologous recombination deficient prostate cancer, and future directions in immunotherapy and nuclear theranostics. DISCUSSION This article summarizes the scientific presentations from the 2022 CHPCA Meeting, with the goal that dissemination of this knowledge will contribute to furthering global prostate cancer research efforts.
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Affiliation(s)
| | - Jessica E Hawley
- Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Remi Adelaiye-Ogala
- Department of Medicine, Division of Hematology and Oncology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Jeremie Calais
- Department of Molecular and Medical Pharmacology, Ahmanson Translational Imaging Division, University of California, Los Angeles, Los Angeles, California, USA
| | - Lucia Nappi
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, British Columbia, Canada
- Department of Medical Oncology, BC Cancer, British Columbia, Canada
| | - Ravi Parikh
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Tyler M Seibert
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
- Department of Bioengineering, University of California San Diego, La Jolla, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Elizabeth V Wasmuth
- Department of Biochemistry and Structural Biology, University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Xiao X Wei
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kenneth J Pienta
- The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Howard R Soule
- Prostate Cancer Foundation, Santa Monica, California, USA
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Taralli S, Cocciolillo F, Alitto AR, Caldarella C. Bone Marrow Activation After Chemotherapy Presenting as Diffuse Skeletal Uptake on 18F-Fluorocholine PET/CT. Clin Nucl Med 2021; 46:e498-e500. [PMID: 34028416 DOI: 10.1097/rlu.0000000000003695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Diffuse 18F-FDG skeletal uptake due to chemotherapy-induced bone marrow activation is well documented, whereas it has never been reported with 18F-fluorocholine. We described a patient with pelvic recurrence of prostate cancer at 18F-fluorocholine PET/CT. A second PET/CT after docetaxel showed minimal residual activity in pelvis, but it revealed diffuse, intense 18F-fluorocholine skeletal uptake. Considering biochemical and metabolic response and absence of morphologically suspected bone lesions, skeletal hyperactivity was interpreted as chemotherapy-related bone marrow rebound rather than diffuse metastatic involvement, as confirmed by its resolution after treatment ended. The occurrence of such 18F-fluorocholine pattern should be considered to avoid imaging misinterpretation.
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Affiliation(s)
| | | | - Anna Rita Alitto
- U.O.C. di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Dreyfuss AD, Ahn GS, Barsky AR, Gillman JA, Vapiwala N, Pantel AR. 18F-Fluciclovine PET/CT in Therapeutic Decision Making for Prostate Cancer: A Large Single-Center Practice-Based Analysis. Clin Nucl Med 2021; 46:187-194. [PMID: 33315672 DOI: 10.1097/rlu.0000000000003444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
METHODS We carried out a retrospective cohort study of patients with BR after primary treatment of PC who received imaging with 18F-fluciclovine PET/CT at our institution between January 2010 and January 2019. PET/CT results were compared with biopsy, conventional imaging results, and/or response to PC therapy. 18F-Fluciclovine PET/CT performance statistics and effects on treatment planning were calculated. RESULTS A total of 328 patients with a median age of 71 years (range, 47-90 years) and median serum prostate-specific antigen level of 1.6 ng/mL (0.02-186.7 ng/mL) were included. Three hundred thirty-six 18F-fluciclovine PET/CT scans were analyzed and classified as positive (65%), negative (25%), or equivocal (10%) based on radiology reports. Sensitivity was 93% (95% confidence interval, 86%-96%) and specificity was 63% (95% confidence interval, 45%-77%). Of patients with known management recommendations post-PET/CT, scan results changed or influenced pre-PET/CT management plans in 73%, and 58% of recommendations involved treatment modality decisions. Overall, 82% of patients' actual management was concordant with post-PET/CT recommendations. Of evaluable patients, 116 (35%) had some form of post-PET radiotherapy included in their care plans, with 95% receiving radiotherapy at a PET-avid target. CONCLUSIONS In the largest single-institutional cohort to date, 18F-fluciclovine PET/CT showed value in the workup of PC in the setting of BR, with noteworthy influence over clinical management decisions. Further studies are needed to evaluate whether PET/CT-based changes in management are associated with improved outcomes.
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Affiliation(s)
- Alexandra D Dreyfuss
- From the Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA
| | - Grace S Ahn
- University of California San Diego School of Medicine, University of California San Diego, La Jolla, CA
| | - Andrew R Barsky
- From the Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA
| | - Jennifer A Gillman
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA
| | - Neha Vapiwala
- From the Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA
| | - Austin R Pantel
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA
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Zukotynski KA, Rowe SP. Histologic Validation of 18F-DCFPyL PET/CT with Comparison to Multiparametric MRI in Biochemically Recurrent Prostate Cancer. Radiology 2020; 296:573-574. [DOI: 10.1148/radiol.2020202098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katherine A. Zukotynski
- Departments of Radiology and Medicine, McMaster University, 1200 Main St W, Room 1P11, Hamilton, ON, Canada L8N 3Z5 (K.A.Z.); and Departments of Radiology, Oncology and Urology, Johns Hopkins University School of Medicine, Baltimore, Md (S.P.R.)
| | - Steven P. Rowe
- Departments of Radiology and Medicine, McMaster University, 1200 Main St W, Room 1P11, Hamilton, ON, Canada L8N 3Z5 (K.A.Z.); and Departments of Radiology, Oncology and Urology, Johns Hopkins University School of Medicine, Baltimore, Md (S.P.R.)
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Pawson A, Ghumman Z, Kuo PH, Jadvar H, Bartel T, Shayegan B, Zukotynski K. A review of prostate cancer imaging, positron emission tomography, and radiopharmaceutical-based therapy. Can Urol Assoc J 2020; 14:130-138. [PMID: 32254013 PMCID: PMC7124170 DOI: 10.5489/cuaj.6506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Amy Pawson
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | - Hossein Jadvar
- University of Southern California, Los Angeles, CA, United States
| | - Twyla Bartel
- Global Advanced Imaging, PLLC, Little Rock, AR, United States
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Akin-Akintayo O, Tade F, Mittal P, Moreno C, Nieh PT, Rossi P, Patil D, Halkar R, Fei B, Master V, Jani AB, Kitajima H, Osunkoya AO, Ormenisan-Gherasim C, Goodman MM, Schuster DM. Prospective evaluation of fluciclovine ( 18F) PET-CT and MRI in detection of recurrent prostate cancer in non-prostatectomy patients. Eur J Radiol 2018; 102:1-8. [PMID: 29685521 DOI: 10.1016/j.ejrad.2018.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/16/2017] [Accepted: 02/06/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the disease detection rate, diagnostic performance and interobserver agreement of fluciclovine (18F) PET-CT and multiparametric magnetic resonance imaging (mpMR) in recurrent prostate cancer. METHODS Twenty-four patients with biochemical failure after non-prostatectomy definitive therapy, 16/24 of whom had undergone brachytherapy, underwent fluciclovine PET-CT and mpMR with interpretation by expert readers blinded to patient history, PSA and other imaging results. Reference standard was established via a multidisciplinary truth panel utilizing histology and clinical follow-up (22.9 ± 10.5 months) and emphasizing biochemical control. The truth panel was blinded to investigative imaging results. Diagnostic performance and interobserver agreement (kappa) for the prostate and extraprostatic regions were calculated for each of 2 readers for PET-CT (P1 and P2) and 2 different readers for mpMR (M1 and M2). RESULTS On a whole body basis, the detection rate for fluciclovine PET-CT was 94.7% (both readers), while it ranged from 31.6-36.8% for mpMR. Kappa for fluciclovine PET-CT was 0.90 in the prostate and 1.0 in the extraprostatic regions. For mpMR, kappa was 0.25 and 0.74, respectively. In the prostate, 22/24 patients met the reference standard with 13 malignant and 9 benign results. Sensitivity, specificity and positive predictive value (PPV) were 100.0%, 11.1% and 61.9%, respectively for both PET readers. For mpMR readers, values ranged from 15.4-38.5% for sensitivity, 55.6-77.8% for specificity and 50.0-55.6% for PPV. For extraprostatic disease determination, 18/24 patients met the reference standard. Sensitivity, specificity and PPV were 87.5%, 90.0% and 87.5%, respectively, for fluciclovine PET-CT, while for mpMR, sensitivity ranged from 50 to 75%, specificity 70-80% and PPV 57-75%. CONCLUSION The disease detection rate for fluciclovine PET-CT in non-prostatectomy patients with biochemical failure was 94.7% versus 31.6-36.8% for mpMR. For extraprostatic disease detection, fluciclovine PET-CT had overall better diagnostic performance than mpMR. For the treated prostate, fluciclovine PET-CT had high sensitivity though low specificity for disease detection, while mpMR had higher specificity, though low sensitivity. Interobserver agreement was also higher with fluciclovine PET-CT compared with mpMR.
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Affiliation(s)
| | - Funmilayo Tade
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Pardeep Mittal
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Courtney Moreno
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Peter T Nieh
- Urology, Emory University, Atlanta, GA, United States
| | - Peter Rossi
- Urology, Emory University, Atlanta, GA, United States
| | | | - Raghuveer Halkar
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Baowei Fei
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Viraj Master
- Urology, Emory University, Atlanta, GA, United States
| | - Ashesh B Jani
- Radiation Oncology, Emory University, Atlanta, GA, United States
| | - Hiroumi Kitajima
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Adeboye O Osunkoya
- Urology, Emory University, Atlanta, GA, United States; Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States
| | - Claudia Ormenisan-Gherasim
- Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States; Pathology, Brigham & Women's Hospital-Harvard Medical School, Boston, MA, United States
| | - Mark M Goodman
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - David M Schuster
- Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States.
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Zaimenko I, Lisec J, Stein U, Brenner W. Approaches and techniques to characterize cancer metabolism in vitro and in vivo. Biochim Biophys Acta Rev Cancer 2017; 1868:412-419. [PMID: 28887205 DOI: 10.1016/j.bbcan.2017.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/22/2017] [Accepted: 08/25/2017] [Indexed: 02/02/2023]
Abstract
Cancer metabolism is wired to sustain uncontrollable cell proliferation and ensure cell survival. Given the multitude of available approaches to study metabolic alterations it remains a challenging task to select the most appropriate method. In this mini-review we describe how cancer metabolism can be studied in vitro and in vivo providing an overview of available approaches and techniques, discussing their advantages and drawbacks and guiding through selection of an appropriate method to address particular research needs. This work is particularly intended to those cancer researchers who are new in the field but want to investigate metabolic alterations in their cancer model systems.
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Affiliation(s)
- Inna Zaimenko
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Max-Delbrück-Center for Molecular Medicine Berlin, Germany; Berlin School of Integrative Oncology, Charité - Universitätsmedizin Berlin, Germany
| | - Jan Lisec
- Metabolomics Unit at Charité - Universitätsmedizin Berlin, Medical Department of Hematology, Oncology, and Tumor Immunology, Molekulares Krebsforschungszentrum (MKFZ), Berlin, Germany; German Cancer Consortium, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Ulrike Stein
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Max-Delbrück-Center for Molecular Medicine Berlin, Germany; German Cancer Consortium, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Winfried Brenner
- German Cancer Consortium, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Germany; Berlin Experimental Radionuclide Imaging Center (BERIC), Charité - Universitätsmedizin Berlin, Germany.
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Jadvar H. Multimodal Imaging in Focal Therapy Planning and Assessment in Primary Prostate Cancer. Clin Transl Imaging 2017; 5:199-208. [PMID: 28713796 DOI: 10.1007/s40336-017-0228-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE There is increasing interest in focal therapy (male lumpectomy) of localized low-intermediate risk prostate cancer. Focal therapy is typically associated with low morbidity and provides the possibility of retreatment. Imaging is pivotal in stratification of men with localized prostate cancer for active surveillance, focal therapy or radical intervention. This article provides a concise review of focal therapy and the evolving role of imaging in this clinical setting. METHODS We performed a narrative and critical literature review by searching PubMed/Medline database from January 1997 to January 2017 for articles in the English language and the use of search keywords "focal therapy", "prostate cancer", and "imaging". RESULTS Most imaging studies are based on multiparametric magnetic resonance imaging. Transrectal ultrasound is inadequate independently but multiparametric ultrasound may provide new prospects. Positron emission tomography with radiotracers targeted to various underlying tumor biological features may provide unprecedented new opportunities. Multimodal Imaging appears most useful in localization of intraprostatic dominant index lesions amenable to focal therapy, in early assessment of therapeutic efficacy and potential need for additional focal treatments or transition to whole-gland therapy, and in predicting short-term and long-term outcomes. CONCLUSION Multimodal imaging is anticipated to play an increasing role in the focal therapy planning and assessment of low-intermediate risk prostate cancer and thereby moving this form of treatment option forward in the clinic.
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Affiliation(s)
- Hossein Jadvar
- Division of Nuclear Medicine, Department of Radiology, University of Southern California, Los Angeles, California, USA
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Bednarova S, Lindenberg ML, Vinsensia M, Zuiani C, Choyke PL, Turkbey B. Positron emission tomography (PET) in primary prostate cancer staging and risk assessment. Transl Androl Urol 2017; 6:413-423. [PMID: 28725583 PMCID: PMC5503952 DOI: 10.21037/tau.2017.03.53] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Prostate cancer (PCa) is one of the few neoplasms that are not well served by 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET). As a result, a number of PET tracers have been developed to target particular biological features of PCa. Such agents can be used for diagnosis, staging, identification of biochemical recurrence (BCR) and evaluation of metastatic disease. Here, we focus on primary disease and local staging. To date, magnetic resonance imaging (MRI) has proven superior to PET in the imaging of primary PCa. However, some PET agents have shown remarkable promise in staging high-risk PCa (defined as any combination of a clinical T3, a PSA score >20 ng/mL, or a Gleason score of 8–10), as well as biochemical relapse after definitive therapy and metastatic PCa. PET agents can be divided into those that interrogate tumor metabolism (18F-FDG, 11C-Choline, 18F-Choline, 11C-Acetate, 18F-FACBC), hormone receptors (18F-FDHT), and other targets such as prostate specific membrane antigen (PSMA) (68Ga-PSMA, 18F-DCFBC, 18F-DCFPyl) or gastric releasing peptide (18F-GRP or 18F-Bombesin). In this review, we compare the available PCa targeted PET tracers utilized in staging of high risk tumors.
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Affiliation(s)
- Sandra Bednarova
- Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy.,Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Maria L Lindenberg
- Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Maria Vinsensia
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Chiara Zuiani
- Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Peter L Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Baris Turkbey
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Wetter A, Grüneisen J, Fliessbach K, Lütje S, Schaarschmidt B, Umutlu L. Choline-based imaging of prostate cancer with combined [ 18F] fluorocholine PET and 1H MR spectroscopy by means of integrated PET/MRI. Clin Imaging 2017; 42:198-202. [PMID: 28110202 DOI: 10.1016/j.clinimag.2016.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/22/2016] [Accepted: 12/16/2016] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate integrated PET/MRI/1H MR spectroscopy in patients with prostate cancer. SUBJECTS AND METHODS Data analysis comprised calculations of correlations of standardized uptake values (SUVs) and ratios of (choline+creatine)/citrate as well as of single metabolite values and a logistic regression analysis of PET data and MR spectroscopy data in 22 patients. RESULTS SUVmean and integral values of choline correlated significantly in tumors. Logistic regression analysis demonstrated diagnostic superiority of PET over spectroscopy. CONCLUSION Simultaneous acquisition of PET and MR spectroscopy with integrated PET/MRI is feasible. Choline compounds and choline metabolism show a positive significant correlation.
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Affiliation(s)
- Axel Wetter
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45122 Essen, Germany.
| | - Johannes Grüneisen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45122 Essen, Germany
| | - Klaus Fliessbach
- Department of Psychiatry, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
| | - Susanne Lütje
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstraße 55, 45122 Essen, Germany
| | - Benedikt Schaarschmidt
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45122 Essen, Germany
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