title: Assessment of Lymph Nodes and Prostate Status Using Early Dynamic Curves with (18)F-Choline PET/CT in Prostate Cancer.
abstract: BACKGROUND
  Dynamic image acquisition with (18)F-Choline [fluorocholine (FCH)] PET/CT in prostate cancer is mostly used to overcome the bladder repletion, which could obstruct the loco-regional analysis. The aim of our study was to analyze early dynamic FCH acquisitions to define pelvic lymph node or prostate pathological status.
  
  
  METHODS
  Retrospective analysis was performed on 39 patients for initial staging (n = 18), or after initial treatment (n = 21). Patients underwent 10-min dynamic acquisitions centered on the pelvis, after injection of 3-4 MBq/kg of FCH. Whole-body images were acquired about 1 h after injection using a PET/CT GE Discovery LS (GE-LS) or Siemens Biograph mCT (mCT). Maximum and mean SUV according to time were measured on nodal and prostatic lesions. SUVmean was corrected for partial volume effect (PVEC) with suitable recovery coefficients. The status of each lesion was based on histological results or patient follow-up (>6 months). A Mann-Whitney test and ANOVA were used to compare mean and receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  The median PSA was 8.46 ng/mL and the median Gleason score was 3 + 4. Ninety-two lesions (43 lymph nodes and 49 prostate lesions) were analyzed, including 63 malignant lesions. In early dynamic acquisitions, the maximum and mean SUV were significantly higher, respectively, on mCT and GE-LS, in malignant versus benign lesions (p < 0.001, p < 0.001). Mean SUV without PVEC, allowed better discrimination of benign from malignant lesions, in comparison with maximum and mean SUV (with PVEC), for both early and late acquisitions. For patients acquired on mCT, area under the ROC curve showed a trend to better sensitivity and specificity for early acquisitions, compared with late acquisitions (SUVmax AUC 0.92 versus 0.85, respectively).
  
  
  CONCLUSIONS
  Assessment of lymph nodes and prostate pathological status with early dynamic imaging using PET/CT FCH allowed prostate cancer detection in situations where proof of malignancy is difficult to obtain.
authors.affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France ; Department of Nuclear Medicine, University Hospital , Nantes , France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Mathieu
authors.affiliation: Centre Régional de Recherche en Cancérologie Nantes/Angers, U892, CNRS UMR 6299, INSERM , Nantes , France ; Department of Medical Physics, ICO Cancer Center , Saint Herblain , France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Ferrer
authors.affiliation: Department of Nuclear Medicine, University Hospital , Nantes , France ; Centre Régional de Recherche en Cancérologie Nantes/Angers, U892, CNRS UMR 6299, INSERM , Nantes , France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Carlier
authors.affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Colombié
authors.affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rusu
authors.affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France ; Department of Nuclear Medicine, University Hospital , Nantes , France ; Centre Régional de Recherche en Cancérologie Nantes/Angers, U892, CNRS UMR 6299, INSERM , Nantes , France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Kraeber-Bodéré
authors.affiliation: Department of Statistics, ICO Cancer Center , Saint Herblain , France.
authors.forename: Loic
authors.initials: L
authors.lastname: Campion
authors.affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France ; Centre Régional de Recherche en Cancérologie Nantes/Angers, U892, CNRS UMR 6299, INSERM , Nantes , France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rousseau
keywords: 18F-choline; dynamic curves; early acquisition; pathological status; prostate cancer