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The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level

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Abstract

Purpose

The aim of this study is to evaluate the potential and limitation of FDG-PET/CT for detecting prostate cancer in subjects with an elevated serum prostate-specific antigen (PSA) level. Although [18F]-2-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) has limited value in detecting prostate cancer, the potential of PET/CT has not been precisely evaluated, since positron emission tomography/computed tomography (PET/CT) provides accurate localization of functional findings obtained by PET.

Methods

Subjects with an increasing PSA level suggestive of prostate cancer were enrolled in this study. FDG-PET/CT was performed prior to prostate biopsy and the findings were compared with the pathological results.

Results

Fifty subjects with an elevated serum PSA level took part in this study. The sensitivity, specificity and positive predictive value (PPV) of FDG-PET/CT in the prostate were 51.9% (27/52 areas), 75.7% (112/148 areas) and 42.9% (27/63 areas), respectively; those in the peripheral zone were 73.3% (22/30 areas), 64.3% (45/70 areas) and 46.8% (22/47 areas), respectively; and those in the central gland were 22.7% (5/22 areas), 85.9% (67/78 areas) and 31.3% (5/16 areas), respectively. The estimated cut-off values according to the highest odds ratio (OR) were age of 70 years [OR: 7.00, 95% confidence interval (CI): 1.89–25.93] and a PSA value of 12.0 ng/ml (OR: 10.77, 95% CI: 2.78–41.74). The FDG-PET/CT could potentially detect cancer with 80.0% sensitivity and 87.0% PPV in cases with a Gleason score of 7 or greater.

Conclusion

FDG-PET/CT was appropriate for detecting peripheral zone prostate cancer in patients at more than an intermediate risk.

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Acknowledgments

This research was supported by Advanced Medical Research Center of Yokohama City University. The authors thank the Kazuo Kubota, M.D., PhD, the chief of Department of Nuclear Medicine, National Center for Global Health and Medicine, for advice to this manuscript. The authors also thank Yokohama City University Hospital, Division of Radiology for technical assistance.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan

    Ryogo Minamimoto

  2. Department of Radiology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Ryogo Minamimoto, Kazuya Shizukuishi, Ukihide Tateishi & Tomio Inoue

  3. Department of Urology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Hiroji Uemura, Futoshi Sano, Hideyuki Terao & Yoshinobu Kubota

  4. Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Yoji Nagashima

  5. Division of Anatomic and Surgical Pathology, Yokohama City University Hospital, Yokohama, Japan

    Shoji Yamanaka

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  1. Ryogo Minamimoto
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  2. Hiroji Uemura
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  9. Yoshinobu Kubota
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  10. Tomio Inoue
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Correspondence to Ryogo Minamimoto.

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Minamimoto, R., Uemura, H., Sano, F. et al. The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level. Ann Nucl Med 25, 21–27 (2011). https://doi.org/10.1007/s12149-010-0424-4

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  • DOI: https://doi.org/10.1007/s12149-010-0424-4

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