Lymph node staging of localized prostatic carcinoma with CT and CT-guided fine-needle aspiration biopsy: prospective study of 285 patients.
OBJECTIVE
To ascertain the reliability of computed tomography (CT) and CT-guided fine-needle aspiration biopsy (FNAB) in staging of lymph nodes in patients with locally confined prostatic carcinoma.


METHODS
A total of 285 patients were studied prospectively. FNAB was performed in 43 patients (15%) with lymph nodes suspect for metastasis on CT scans. FNAB findings were correlated with either the findings of the pathologic examination performed after lymph node dissection (LND) or the status of the lymph node at follow-up with CT after hormone therapy.


RESULTS
The sensitivity, specificity, and accuracy of CT-guided FNAB were 77.8%, 100%, and 96.5%. If CT only had been performed, these results would have been 77.8%, 96.7%, and 93.7%. CT staging was false-negative in only 10 patients, who had microscopic metastatic deposits in a solitary lymph node.


CONCLUSIONS
Combined CT and FNAB is highly efficient for assessment of lymph node metastasis. Therefore, it could be considered an alternative to surgical or laparoscopic lymphadenectomy in patients scheduled for radical prostatectomy or curative radiation therapy.
Oyen
R H
RH
Department of Radiology, University Hospitals, Catholic University of Leuven, Belgium.
Van Poppel
H P
HP
Ameye
F E
FE
Van de Voorde
W A
WA
Baert
A L
AL
Baert
L V
LV
D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed