Comparison of 11C-choline-PET/CT and whole body-MRI for staging of prostate cancer.
Aim of this study was to compare the diagnostic accuracy of positron emission tomography and computed tomography with (11)C-Choline (Cho-PET/CT) and whole body magnetic resonance imaging (WB-MRI) for diagnostic work-up of prostate cancer.


METHODS
We evaluated retrospectively 42 patients with untreated prostate cancer (n = 17), or increasing levels of prostate-specific antigen (PSA) after curative therapy (n = 25) who had been investigated by both Cho-PET/CT and WB-MRI. MRI, CT, and PET images were separately analyzed by experienced radiologists or nuclear medicine experts, followed by consensus reading. Validation was established by histology, follow-up, or consensus reading.


RESULTS
88/103 detected lesions were considered as malignant: 44 bone metastases, 22 local tumor, 15 lymph node metastases, 3 lung, and 3 brain metastases. One further lesion was located in the adrenal gland, which was a second tumor. Overall sensitivity, specificity and accuracy for Cho-PET/CT were 96.6%, 76.5%, and 93.3%, resp., and for WB-MRI 78.4%, 94.1%, and 81.0%, resp. 3 vertebral metastases had initially been missed by Cho-PET/CT and were found retrospectively. MRI identified 2 bone metastases and 1 lymph node metastasis after being informed about the results of Cho-PET/CT.


CONCLUSIONS
Cho-PET/CT and WB-MRI both presented high accuracy in the detection of bone and lymph node metastases. The strength of MRI is excellent image quality providing detailed anatomical information whereas the advantage of Cho-PET/CT is high image contrast of pathological foci.
Eschmann
S M
SM
Department of Nuclear Medicine, Eberhard-Karls-Universität Tübingen, Germany.
Pfannenberg
A C
AC
Rieger
A
A
Aschoff
P
P
Müller
M
M
Paulsen
F
F
Anastasiadis
A
A
Claussen
C D
CD
Bares
R
R
Schlemmer
H P
HP
D001859:Bone Neoplasms / Q000556:secondary; D002250:Carbon Radioisotopes; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D002250:Carbon Radioisotopes