Radioimmunoguided imaging of prostate cancer foci with histopathological correlation.
OBJECTIVE
We have previously presented a technique that fuses ProstaScint and pelvic CT images for the purpose of designing brachytherapy that targets areas at high risk for treatment failure. We now correlate areas of increased intensity seen on ProstaScint-CT fusion images to biopsy results in a series of 7 patients to evaluate the accuracy of this technique in localizing intraprostatic disease.


METHODS
The 7 patients included in this study were evaluated between June 1998 and March 29, 1999 at Metrohealth Medical Center and University Hospitals of Cleveland in Cleveland, Ohio. ProstaScint and CT scans of each patient were obtained before transperineal biopsy and seed implantation. Each patient's prostate gland was biopsied at 12 separate sites determined independently of Prostascint-CT scan results.


RESULTS
When correlated with biopsy results, our method yielded an overall accuracy of 80%: with a sensitivity of 79%, a specificity of 80%, a positive predictive value of 68%, and a negative predictive value of 88%.


CONCLUSIONS
The image fusion of the pelvic CT scan and ProstaScint scan helped identify foci of adenocarcinoma within the prostate that correlated well with biopsy results. These data may be useful to escalate doses in regions containing tumor by either high-dose rate or low-dose rate brachytherapy, as well as by external beam techniques such as intensity modulated radiotherapy (IMRT).
Ellis
R J
RJ
Department of Radiation Oncology, University Hospitals of Cleveland, Cleveland, OH 44106, USA. rod.ellis@uhhs.com
Kim
E Y
EY
Conant
R
R
Sodee
D B
DB
Spirnak
J P
JP
Dinchman
K H
KH
Beddar
S
S
Wessels
B
B
Resnick
M I
MI
Kinsella
T J
TJ
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000911:Antibodies, Monoclonal; D001706:Biopsy; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016719:Radioimmunodetection / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D000911:Antibodies, Monoclonal; D007205:Indium Radioisotopes; C101315:Capromab Pendetide