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  • Canadian Urological Association Journal  (3)
  • 1
    Online Resource
    Online Resource
    Initial single-centre Canadian experience with 18F-fluoromethylcholine positron emission tomography-computed tomography (18F-FCH PET/ CT) for biochemical recurrence in prostate cancer patients initially treated with curative intent
    Canadian Urological Association Journal ; 2017
    In:  Canadian Urological Association Journal Vol. 11, No. 1-2 ( 2017-02-20), p. 47-
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 11, No. 1-2 ( 2017-02-20), p. 47-
    Abstract: Introduction: We sought to determine predictive factors (patient and prostate- specific antigen [PSA] characteristics) for 18F-fluoromethylcholine positron emission tomography-computed tomography (18F-FCH PET/ CT) positivity in the context of biochemical recurrence after local treatment of prostate cancer (PCa) with curative intent.Methods: This is a retrospective study including 60 18F-FCH PET/ CT scans of patients with biochemical recurrence after initial radical prostatectomy (RP), external beam radiation therapy (EBRT), or focal high-intensity focused ultrasound (HIFU) with curative intent. The results were compared to findings on magnetic resonance imaging (MRI), computed tomography (CT), bone scan (BS), and histological analysis when available. Univariate analysis was performed to correlate results with patient characteristics.Results: Thirty-eig ht (63.3%) scans were positive, 17 (28.3%) negative, and 5 (8.3%) equivocal. Of the positive scans, 16 demonstrated local recurrence, 12 regional/distant lymph nodes, five bone metastasis, and five local and distant recurrences. Among the 22 PET/CTs showing metastasis, conventional imaging was performed in 16 patients (72.7%). Of these, it demonstrated the lesion(s) found on PET/CT in eight patients (50.0%), was negative in seven (43.8%), and equivocal in one (6.3%). The trigger PSA (p=0.04), prostate-specific antigen velocity (PSAV) (p=0.03), and prostate-specific antigen doubling time (PSADT) (p=0.046) were significantly different when comparing positive and negative scans. Patients with positive scans were more likely to have received EBRT initially (odds ratio [OR] 11.0, 95% confidence interval [CI] 2.2‒55.3). A trigger PSA of 2.6 ng/mL had a sensitivity of 84% and specificity of 65% for a positive scan. PET/CT changed the clinical management plan in 17 patients (28.3%).Conclusions: 18F-FCH PET/CT demonstrates a high detection rate for local and distant recurrences after localized PCa treatment. A trigger PSA above 2.6 ng/mL seems optimal for appropriate patient selection.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.4068
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2017
    detail.hit.zdb_id: 2431403-1
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    Online Resource
  • 2
    Online Resource
    Online Resource
    18F-fluorocholine positron emission tomography-computed tomography (18F-FCH PET/CT) for staging of high-risk prostate cancer patients
    Canadian Urological Association Journal ; 2018
    In:  Canadian Urological Association Journal Vol. 13, No. 4 ( 2018-09-25)
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 13, No. 4 ( 2018-09-25)
    Abstract: Introduction: We sought to evaluate the diagnostic performance of 18F-fluorocholine positron emission tomography-computed tomography (18F-FCH PET/CT) for initial staging of patients with high-risk prostate cancer. Secondary objectives were to compare the value of 18F-FCH PET/CT to conventional imaging modalities and to evaluate its clinical impact. Methods: We conducted a retrospective study of 76 patients who underwent 18F-FCH PET/CT for initial staging of high-risk prostate cancer. Using pre-established validation criteria, sensitivity and specificity were determined for metastatic disease. Results were compared to findings on magnetic resonance imaging (MRI), computed tomography (CT), and bone scan (BS) when available. Results: Twenty-two (29%) PET/CT scans were positive, 49 (64%) negative, and five (7%) equivocal for nodal or metastatic disease. Of the positive scans, 17 showed regional lymph node involvement, 12 distant nodes, five bone metastases, and three lung metastases. Overall per-patient sensitivity, specificity, positive and negative predictive values for metastatic disease were 65%, 100%, 100%, and 78%, respectively. Sensitivity, specificity, and positive and negative predictive values were 64%, 100%, 100%, and 80%, respectively, for nodal involvement and 86%, 100%, 100%, and 98%, respectively, for bone and other metastases. Conventional imaging was negative for the lesion(s) found on PET/CT in five patients. PET/CT changed the clinical management in nine patients (12%). Conclusions: Although 18F-FCH PET/CT offers some benefits over conventional imaging and demonstrates a high specificity, it remains limited by its sensitivity in the context of high-risk prostate cancer staging. PET with novel urea-based small molecule prostate-specific membrane antigen (PSMA) inhibitors may overcome some of these limitations. However, the interpretation of the study result is limited by the lack of available histological gold standard, the inclusion of several patients who received androgen-deprivation therapy (ADT) prior to PET/CT, our retrospective design, and a relatively small sample size.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.5142
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2018
    detail.hit.zdb_id: 2431403-1
    Location Call Number Limitation Availability
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  • 3
    Online Resource
    Online Resource
    Diagnostic performance of 18F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis
    Canadian Urological Association Journal ; 2020
    In:  Canadian Urological Association Journal Vol. 15, No. 6 ( 2020-11-17)
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 15, No. 6 ( 2020-11-17)
    Abstract: Introduction: Conventional imaging (CI) performs poorly to identify sites of disease in biochemically recurrent prostate cancer. 68Ga-PSMA-11 positron emission tomography/ computed tomography (PET/CT) is most studied but has a very short half-life. This study reports the diagnostic performance of the novel prostate-specific membrane antigen (PSMA) radiotracer 18F-DCFPyL using real-life data, and tumor board simulation to estimate the impact of 18F-DCFPyL PET on patient management. Methods: Ninety-three 18F-DCFPyL PET/CT scans performed for patients previously treated for prostate cancer with a rising prostate-specific antigen (PSA) were retrospectively compared to contemporary CI, and clinical, imaging and PSA followups. A chart review was performed to document prior imaging, pathology results, serial serum PSA measurements, and other pertinent clinical data. Clinical utility of 18F-DCFPyL PET was measured using a simulated tumor board formed by three physicians with extensive prostate cancer experience deciding on management with and without knowledge of PET/CT results. Results: At median PSA 2.27 (interquartile range [IQR] 5.27] , 82% of 18F-DCFPyL PET/CT demonstrated at least one site of disease: non-regional lymph nodes (37% of scans), regional lymph node metastases (28%), local recurrence (27%), bone metastases (20%), with higher PET positivity at higher PSA. Compared to 18F-DCFPyL PET/CT, CI showed overall poor performance, with accuracy below 20% for all extent of disease. PET/CT changed management in 44% of cases. The most frequent scenario was a radical change from initiating androgen deprivation therapy (ADT) to stereotactic body radiotherapy (SBRT) of oligo-lesional disease. In univariate and multivariate analysis, no patient characteristic could predict change of management by PET/CT results. Conclusions: 18F-DCFPyL significantly outperforms CI in recurring prostate cancer and is likely to impact management.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.6817
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2020
    detail.hit.zdb_id: 2431403-1
    Location Call Number Limitation Availability
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