C-11 choline PET/CT imaging for differentiating malignant from benign prostate lesions.
OBJECTIVE
To investigate the potential of C-11 choline PET/CT imaging for differentiating prostate cancer (PCa) from benign prostate hyperplasia (BPH).


METHODS
Forty-nine patients with prostate lesions underwent C-11 choline PET/CT imaging that was performed 5 minutes after injection of 7.4 MBq/kg (0.2 mCi/kg C-11 choline in the supine position over 2 bed positions (3 minutes per position), covering the pelvis, and the whole body (6 bed) when necessary. After attenuation correction, PET data were analyzed visually and semiquantitatively by measuring maximum standardized uptake value (SUVmax) of the prostate lesions (target) and the muscles (nontarget) and calculating their ratios (P/M).


RESULTS
Twenty-one PCa and 28 BPH lesions were proven histologically. The mean values of the SUVmax of PCa and BPH were 7.87 +/- 5.74 and 4.95 +/- 5.14, respectively without a significant difference between these 2 groups (t = 2.02; P > 0.05). The mean P/M of PCa and BPH were 4.21 +/- 1.61 and 1.87 +/- 0.98. The statistical difference of P/M between them was significant (t = 2.04; P < 0.01). Using 2.3 (P/M) as the criterion, C-11 choline PET/CT imaging showed a sensitivity of 90.48%, a specificity of 85.71%, and a negative predictive value of 92.31%. PET/CT precise localization of the hot spot in different parts of the prostate could contribute to the diagnosis.


CONCLUSIONS
C-11 choline PET/CT is a valuable noninvasive imaging technology in the diagnosis of PCa. The parameter P/M could differentiate PCa from benign lesions better than SUV.
Li
Xin
X
PET/CT Center, Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, China.
Liu
Qi
Q
Wang
Muwen
M
Jin
Xunbo
X
Liu
Qingwei
Q
Yao
Shuzhan
S
Liu
Songtao
S
Li
Jun
J
D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes; D002794:Choline; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*
D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D002794:Choline