title: Comparison of [(11)C]choline Positron Emission Tomography With T2- and Diffusion-Weighted Magnetic Resonance Imaging for Delineating Malignant Intraprostatic Lesions.
abstract: OBJECTIVE
  The purpose of this study was to compare the accuracy of [(11)C]choline positron emission tomography (CHOL-PET) with that of the combination of T2-weighted and diffusion-weighted (T2W/DW) magnetic resonance imaging (MRI) for delineating malignant intraprostatic lesions (IPLs) for guiding focal therapies and to investigate factors predicting the accuracy of CHOL-PET.
  
  
  METHODS
  This study included 21 patients who underwent CHOL-PET and T2W/DW MRI prior to radical prostatectomy. Two observers manually delineated IPL contours for each scan, and automatic IPL contours were generated on CHOL-PET based on varying proportions of the maximum standardized uptake value (SUV). IPLs identified on prostatectomy specimens defined reference standard contours. The imaging-based contours were compared with the reference standard contours using Dice similarity coefficient (DSC), and sensitivity and specificity values. Factors that could potentially predict the DSC of the best contouring method were analyzed using linear models.
  
  
  RESULTS
  The best automatic contouring method, 60% of the maximum SUV (SUV60) , had similar correlations (DSC: 0.59) with the manual PET contours (DSC: 0.52, P=.127) and significantly better correlations than the manual MRI contours (DSC: 0.37, P<.001). The sensitivity and specificity values were 72% and 71% for SUV60; 53% and 86% for PET manual contouring; and 28% and 92% for MRI manual contouring. The tumor volume and transition zone pattern could independently predict the accuracy of CHOL-PET.
  
  
  CONCLUSIONS
  CHOL-PET is superior to the combination of T2W/DW MRI for delineating IPLs. The accuracy of CHOL-PET is insufficient for gland-sparing focal therapies but may be accurate enough for focal boost therapies. The transition zone pattern is a new classification that may predict how well CHOL-PET delineates IPLs.
authors: Radiation Oncology Centre, Austin Health, Victoria, Australia; University of Melbourne, Victoria, Australia.
authors: Joe H
authors: JH
authors: Chang
authors: Radiation Oncology Centre, Austin Health, Victoria, Australia.
authors: Daryl
authors: D
authors: Lim Joon
authors: Monash University Eastern Health Clinical School, Victoria, Australia.
authors: Ian D
authors: ID
authors: Davis
authors: University of Melbourne, Victoria, Australia; Centre for PET, Austin Health, Victoria, Australia; Ludwig Institute for Cancer Research, Victoria, Australia.
authors: Sze Ting
authors: ST
authors: Lee
authors: Department of Radiology, Austin Health, Victoria, Australia.
authors: Chee-Yan
authors: CY
authors: Hiew
authors: Department of Radiology, Austin Health, Victoria, Australia.
authors: Stephen
authors: S
authors: Esler
authors: Centre for PET, Austin Health, Victoria, Australia.
authors: Sylvia J
authors: SJ
authors: Gong
authors: Radiation Oncology Centre, Austin Health, Victoria, Australia.
authors: Morikatsu
authors: M
authors: Wada
authors: Tissupath, Mt Waverley, Victoria, Australia.
authors: David
authors: D
authors: Clouston
authors: Healthcare Imaging, Epworth Hospital, Victoria, Australia.
authors: Richard
authors: R
authors: O'Sullivan
authors: Diagnostic Imaging, Monash Health, Victoria, Australia.
authors: Yin P
authors: YP
authors: Goh
authors: Department of Urology, Austin Health, Victoria, Australia.
authors: Damien
authors: D
authors: Bolton
authors: University of Melbourne, Victoria, Australia; Centre for PET, Austin Health, Victoria, Australia; Ludwig Institute for Cancer Research, Victoria, Australia.
authors: Andrew M
authors: AM
authors: Scott
authors: Radiation Oncology Centre, Austin Health, Victoria, Australia; University of Melbourne, Victoria, Australia; Royal Marsden Hospital, National Health Service Foundation Trust, London, United Kingdom; Department of Medical Imaging and Radiation Sciences, Monash University, Victoria, Australia. Electronic address: vincent.khoo@rmh.nhs.uk.
authors: Vincent
authors: V
authors: Khoo
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002250:Carbon Radioisotopes; D002794:Choline; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019275:Radiopharmaceuticals; D012015:Reference Standards; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017430:Prostate-Specific Antigen; D002794:Choline