Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients

Journal of Nuclear Medicine

Anna Rita Cervino¹  Federica Guidoccio¹  Duccio Volterrani¹  Tanja Baseric¹  Giorgio Saladini¹  Eugenio Borsatti¹  Giulia Puccini¹  Valentina Bodanza¹  Marino Cimitan¹  Michele Gregianin¹  Jure Fettich¹  Laura Evangelista¹  Giuliano Mariani¹  Marina Hodolič¹ 

关键词: ¹⁸F-choline PET;    Gleason score;    prostate cancer;    PSA;    restaging;   

DOI  :  10.2967/jnumed.114.141887

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The objective of this study was to explore the ability of the initial Gleason score (GS) to predict the rate of detection of recurrent prostate cancer (PCa) with 18F-choline PET/CT in a large cohort of patients. Methods: Data from 1,000 patients who had undergone 18F-choline PET/CT because of biochemical evidence of relapse of PCa between 2004 and 2013 were retrieved from databases at 4 centers. Continuous data were compared by the Student t test or ANOVA, and categoric variables were compared by the χ2 test. Univariable and multivariable analyses were performed by logistic regression. Results: The GS at diagnosis was less than or equal to 6 in 257 patients, 7 in 347 patients, and greater than 7 in 396 patients. The results of 645 PET/CT scans were positive for PCa recurrence. Eighty-one percent of the positive PET/CT results were found in patients with a PSA level of greater than or equal to 2 ng/mL, 43% were found in patients with a PSA level of 1–2 ng/mL, and 31% were found in patients with a PSA level of less than or equal to 1 ng/mL; 78.8% of patients with positive PET/CT results had a GS of greater than 7. The results of 18F-choline PET/CT scans were negative in 300 patients; 44% had a GS of less than or equal to 6, 35% had a GS of 7, and 17% had a GS of greater than 7. PET/CT results were rated as doubtful in only 5.5% of patients (median PSA, 1.8 ng/mL). When the GS was greater than 7, the rates of detection of 18F-choline PET/CT were 51%, 65%, and 91% for a PSA level of less than 1 ng/mL, 1–2 ng/mL, and greater than 2 ng/mL, respectively. In univariable and multivariable analyses, both a GS of 7 and a GS of greater than 7 were independent predictors for positive 18F-choline PET/CT results (odds ratios, 0.226 and 0.330, respectively; P values for both, <0.001). Conclusion: A high GS at diagnosis is a strong predictive factor for positive 18F-choline PET/CT scan results for recurrent PCa, even when the PSA level is low (i.e., ≤1 ng/mL).

【 授权许可】

Unknown