title: Incidental prostate ¹⁸F-FDG uptake without calcification indicates the possibility of prostate cancer.
abstract: Incidental 18F-fluorodeoxyglucose (18F-FDG) uptake in the prostate is often experienced in clinical practice; however, it is difficult to determine whether incidental uptake is indicative of a malignancy or benign state based on the maximum standardized uptake value (SUVmax). In the present study, we investigated the clinical significance of incidental prostate uptake by 18F-FDG positron emission tomography (PET)/CT, and examined the differences between malignant and benign uptake from a clinicopathological viewpoint. We reviewed 3,236 male subjects who underwent 18F-FDG PET/CT scans at Hirosaki University Hospital (Japan) from 2008 to 2012 in order to identify cases of incidental prostate FDG uptake. The final diagnosis was made by serum prostate-specific antigen (PSA) levels, biopsy, imaging studies and clinical follow-up with PET findings. Incidental FDG uptake of the prostate was observed in 53 cases (2%). Four cases were excluded due to insufficient clinical data, and 49 cases were included in the present study. Of the 49 cases, 8 (16%) had prostate cancer, while 41 (84%) were benign. All 8 malignant cases had high uptake areas, e.g. in the prostate peripheral zone, where there was no coexistence of calcification or FDG uptake. Of the 41 benign cases, 19 had high uptake in the inner zone, 17 in the peripheral zone, and 5 in both the inner and peripheral zones. Of the 41 cases, 18 (44%) showed FDG uptake coexisting with prostatic calcification. Incidental prostate 18F-FDG uptake infrequently signifies prostate cancer; however, FDG uptake not coexisting with calcification indicates the possibility of prostate cancer and should be included in the differential diagnosis for performing other clinical examinations.
authors: Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Hiroko
authors: H
authors: Seino
authors: Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Shuichi
authors: S
authors: Ono
authors: Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Hiroyuki
authors: H
authors: Miura
authors: Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Satoko
authors: S
authors: Morohashi
authors: Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Yunyan
authors: Y
authors: Wu
authors: Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Fumiyasu
authors: F
authors: Tsushima
authors: Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Yoshihiro
authors: Y
authors: Takai
authors: Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors: Hiroshi
authors: H
authors: Kijima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D033162:Incidental Findings; D007564:Japan; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18