title: Comparison between conventional imaging (abdominal-pelvic computed tomography and bone scan) and [(18)F]choline positron emission tomography/computed tomography imaging for the initial staging of patients with intermediate- tohigh-risk prostate cancer: A retrospective analysis.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficiency of [(18)F]fluorocholine positron emission tomography/computed tomography (FCH PET/CT) in detecting lymph-node and bone involvement in comparison with conventional imaging, such as abdominal-pelvic CT and bone scan, in the initial staging of prostate cancer (PCa).
  
  
  METHODS
  The study retrospectively evaluated 48 patients who had FCH PET/CT for the initial staging of PCa. At the same time, 32 of the 48 patients had a bone scan and 26 of the 48 patients had abdominal-pelvic diagnostic CT. Diagnostic performance of FCH PET/CT, i.e. sensitivity, specificity and accuracy, was evaluated on a per-patient basis for the whole population and then separately on a per-risk classification, and later in comparison with conventional imaging. Histological specimens or follow-up data were used as the standard of reference.
  
  
  RESULTS
  The overall accuracy of FCH PET/CT for lymph-node involvement was 83.3%. The sensitivity of FCH was higher in the high-risk subset (83.3%) than in the intermediate-risk group (33.3%), whereas FCH specificity was similar. In comparison with dedicated CT scan, FCH PET/CT showed a higher sensitivity and a similar specificity (46.2% vs 69.2% and 92.3% vs 92.3%, respectively). Moreover, the sensitivity and specificity of PET/CT were higher than those of bone scan (100% vs 90% and 86.4% vs 77.2%, respectively). In contrast with conventional imaging, PET/CT changed the staging of the PCa in 33.3% patients.
  
  
  CONCLUSIONS
  The efficiency of FCH PET/CT in detecting both bone and lymph-node involvement of PCa at initial staging was found to be higher than that of conventional imaging. Prospective clinical trials are needed to confirm these findings.
authors: a 1 Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV-IRCCS , Padua, Italy.
authors: Laura
authors: L
authors: Evangelista
authors: b 2 Nuclear Medicine Unit, National Cancer Institute CRO-IRCCS , Aviano (PN), Italy , and.
authors: Marino
authors: M
authors: Cimitan
authors: c 3 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua , Italy.
authors: Fabio
authors: F
authors: Zattoni
authors: c 3 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua , Italy.
authors: Andrea
authors: A
authors: Guttilla
authors: c 3 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua , Italy.
authors: Filiberto
authors: F
authors: Zattoni
authors: a 1 Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV-IRCCS , Padua, Italy.
authors: Giorgio
authors: G
authors: Saladini
mesh_terms: D000005:Abdomen; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary; D002794:Choline / Q000008:administration & dosage / Q000031:analogs & derivatives; D005462:Fluorine Radioisotopes / Q000008:administration & dosage; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods; D010388:Pelvis; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012306:Risk; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005462:Fluorine Radioisotopes; C514960:fluorocholine; D002794:Choline
keywords: Bone scan; choline PET; computed tomography; prostate cancer; staging