title: Prevalence and clinical significance of incidental (18)F-fluoro-2-deoxyglucose uptake in prostate.
abstract: OBJECTIVE
  To investigate the prevalence and clinical significance of incidental prostate fluoro-2-deoxyglucose (FDG) uptake and to evaluate its impact on patient management.
  
  
  METHODS
  Of 47,109 men who underwent FDG positron emission tomography between 2004 and 2014, 1,335 (2.83%) demonstrated incidental FDG uptake in the prostate, with 99 of the latter undergoing prostate biopsy. The primary end point was the histological presence of prostate adenocarcinoma in the biopsy specimen. Outcomes, including treatment methods, survival, and causes of death, were also assessed. Factors associated with the diagnosis of prostate cancer were evaluated by using logistic regression analysis.
  
  
  RESULTS
  Patients with prostate cancer were more likely to have higher serum prostate-specific antigen (PSA) (p=0.001) and focal FDG uptake (p=0.036) than were those without. Prostate cancer occurred in 1 of 26 patients (3.8%) with serum PSA<2.5 ng/mL, compared with 40 of 67 patients (59.7%) with serum PSA≥2.5 ng/mL. Multivariable analysis showed that focal lesions (odds ratio [OR], 5.50; p=0.038), age (OR, 1.06; p=0.031), and serum PSA (OR, 1.28; p=0.001) were independent predictors of prostate cancer diagnosis. Most patients with prostate cancer had organ-confined tumors. Of these, 12 (29.3%) underwent radical prostatectomy and 25 (60.9%) received hormone therapy. Of the 11 patients who died, 9 died of primary cancer progression, with only 1 patient dying from prostate cancer.
  
  
  CONCLUSIONS
  The prevalence of incidental FDG uptake in the prostate was not high, although patients with elevated serum PSA had a higher incidence of prostate cancer. Patients with FDG uptake in the prostate should be secondarily evaluated by measuring serum PSA, with those having high serum PSA undergoing prostate biopsy.
authors: Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. ; Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Taekmin
authors: T
authors: Kwon
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: In Gab
authors: IG
authors: Jeong
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Dalsan
authors: D
authors: You
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jun Hyuk
authors: JH
authors: Hong
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Hanjong
authors: H
authors: Ahn
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Choung-Soo
authors: CS
authors: Kim
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D000368:Aged; D001706:Biopsy; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D049268:Positron-Emission Tomography / Q000009:adverse effects*; D015995:Prevalence; D011467:Prostate / Q000187:drug effects / Q000473:pathology; D011468:Prostatectomy / Q000379:methods / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D014018:Tissue Distribution
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Incidental findings; Positron-emission tomography; Prostate neoplasms