title: Improved detection of localized prostate cancer using co-registered MRI and 11C-acetate PET/CT.
abstract: OBJECTIVE
  We aimed to study the ability of contrast enhanced MRI at 1.5 T and 11C-acetate PET/CT, both individually and using fused data, to detect localized prostate cancer.
  
  
  METHODS
  Thirty-six men with untreated prostate cancer and negative for metastatic disease on pelvic CT and bone scan were prospectively enrolled. A pelvic 11C-acetate PET/CT scan was performed in all patients, and a contrast enhanced MRI scan in 33 patients (6 examinations using both endorectal coil and surface coils, and 27 examinations using surface coils only). After the imaging studies 10 patients underwent prostatectomy and 26 were treated by image guided external beam radiation treatment. Image fusion of co-registered PET and MRI data was performed based on anatomical landmarks visible on CT and MRI using an advanced in-house developed software package. PET/CT, MRI and fused PET/MRI data were evaluated visually and compared with biopsy findings on a lobar level, while a sextant approach was used for patients undergoing prostatectomy.
  
  
  RESULTS
  When using biopsy samples as method of reference, the sensitivity, specificity and accuracy for visual detection of prostate cancer on a lobar level by contrast enhanced MRI was 85%, 37%, 73% and that of 11C-acetate PET/CT 88%, 41%, 74%, respectively. Fusion of PET with MRI data increased sensitivity, specificity and accuracy to 90%, 72% and 85%, respectively.
  
  
  CONCLUSIONS
  Fusion of sequentially obtained PET/CT and MRI data for the localization of prostate cancer is feasible and superior to the performance of each individual modality alone.
authors.affiliation: Department of Diagnostic Radiology, University of Turku, and Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland. ivjamb@utu.fi
authors.forename: Ivan
authors.initials: I
authors.lastname: Jambor
authors.forename: Ronald
authors.initials: R
authors.lastname: Borra
authors.forename: Jukka
authors.initials: J
authors.lastname: Kemppainen
authors.forename: Virva
authors.initials: V
authors.lastname: Lepomäki
authors.forename: Riitta
authors.initials: R
authors.lastname: Parkkola
authors.forename: Kirsti
authors.initials: K
authors.lastname: Dean
authors.forename: Kalle
authors.initials: K
authors.lastname: Alanen
authors.forename: Eveliina
authors.initials: E
authors.lastname: Arponen
authors.forename: Martti
authors.initials: M
authors.lastname: Nurmi
authors.forename: Hannu J
authors.initials: HJ
authors.lastname: Aronen
authors.forename: Heikki
authors.initials: H
authors.lastname: Minn
mesh_terms: D000085:Acetates; D000368:Aged; D002244:Carbon; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed
chemical_list: D000085:Acetates; D019275:Radiopharmaceuticals; C438206:carbon-11 acetate; D002244:Carbon