title: Diffusion-weighted MRI, 11C-choline PET and 18F-fluorodeoxyglucose PET for predicting the Gleason score in prostate carcinoma.
abstract: OBJECTIVE
  To evaluate the accuracy of transrectal ultrasound-guided (TRUS) biopsy, diffusion-weighted (DW) magnetic resonance imaging (MRI), (11)C-choline (CHOL) positron emission tomography (PET), and (18)F-fluorodeoxyglucose (FDG) PET in predicting the prostatectomy Gleason risk (GR).
  
  
  METHODS
  The study included 21 patients who underwent TRUS biopsy and multi-technique imaging before radical prostatectomy. Values from five different tests (TRUS biopsy, DW MRI, CHOL PET, FDG PET, and combined DW MRI/CHOL PET) were correlated with the prostatectomy GR using Spearman's ρ. Tests that were found to have significant correlations were used to classify patients into GR groups.
  
  
  RESULTS
  The following tests had significant correlations with prostatectomy GR: TRUS biopsy (ρ = 0.617, P = 0.003), DW MRI (ρ = -0.601, P = 0.004), and combined DW MRI/CHOL PET (ρ = -0.623, P = 0.003). CHOL PET alone and FDG PET only had weak correlations. The correct GR classification rates were 67% with TRUS biopsy, 67% with DW MRI, and 76% with combined DW MRI/CHOL PET.
  
  
  CONCLUSIONS
  DW MRI and combined DW MRI/CHOL PET have significant correlations and high rates of correct classification of the prostatectomy GR, the strength and accuracy of which are comparable with TRUS biopsy.
  
  
  CONCLUSIONS
  • Accurate determination of the Gleason score is essential for prostate cancer management. • DW MRI ± CHOL PET correlated significantly with prostatectomy Gleason score. • These correlations are similar to that between TRUS biopsy and prostatectomy.
authors.affiliation: Radiation Oncology Centre, Austin Health, 300 Waterdale Road, Heidelberg, VIC, 3084, Australia, joe.chang@austin.org.au.
authors.forename: Joe H
authors.initials: JH
authors.lastname: Chang
authors.forename: Daryl
authors.initials: D
authors.lastname: Lim Joon
authors.forename: Sze Ting
authors.initials: ST
authors.lastname: Lee
authors.forename: Chee-Yan
authors.initials: CY
authors.lastname: Hiew
authors.forename: Stephen
authors.initials: S
authors.lastname: Esler
authors.forename: Sylvia J
authors.initials: SJ
authors.lastname: Gong
authors.forename: Morikatsu
authors.initials: M
authors.lastname: Wada
authors.forename: David
authors.initials: D
authors.lastname: Clouston
authors.forename: Richard
authors.initials: R
authors.lastname: O'Sullivan
authors.forename: Yin P
authors.initials: YP
authors.lastname: Goh
authors.forename: Henri
authors.initials: H
authors.lastname: Tochon-Danguy
authors.forename: J Gordon
authors.initials: JG
authors.lastname: Chan
authors.forename: Damien
authors.initials: D
authors.lastname: Bolton
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Scott
authors.forename: Vincent
authors.initials: V
authors.lastname: Khoo
authors.forename: Ian D
authors.initials: ID
authors.lastname: Davis
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000368:Aged; D001706:Biopsy / Q000379:methods; D002250:Carbon Radioisotopes; D002794:Choline; D038524:Diffusion Magnetic Resonance Imaging / Q000592:standards; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D049268:Positron-Emission Tomography / Q000592:standards; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002794:Choline