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Usefulness of MRI-assisted metabolic volumetric parameters provided by simultaneous 18F-fluorocholine PET/MRI for primary prostate cancer characterization

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to determine the usefulness of MRI-assisted positron emission tomography (PET) parameters provided by simultaneous 18F-fluorocholine (FCH) PET/MRI for characterization of primary prostate cancer.

Methods

Thirty patients with localized prostate cancer (mean age 69.4 ± 6.7 years) confirmed by biopsy were prospectively enrolled for simultaneous PET/MRI imaging. The patients underwent 18F-FCH PET/MRI 1 week before undergoing total prostatectomy. Multiple parameters of diffusion-weighted MRI [minimum and mean apparent diffusion coefficient (ADCmin and ADCmean)], metabolic PET [maximum and mean standardized uptake value (SUVmax and SUVmean)], and metabolic volumetric PET [metabolic tumor volume (MTV) and uptake volume product (UVP)] were compared with laboratory, pathologic, and immunohistochemical (IHC) features of the prostate cancer specimen. PET parameters were divided into two categories as follows: volume of interest (VOI) of prostate by SUV cutoff 2.5 (SUVmax, SUVmean, MTVSUV, and UVPSUV) and MRI-assisted VOI of prostate cancer (SUVmaxMRI, SUVmeanMRI, MTVMRI, and UVPMRI).

Results

The rates of prostate cancer-positive cases identified by MRI alone, 18F-FCH PET alone, and 18F-FCH PET/MRI were 83.3, 80.0, and 93.3 %, respectively. Among the multiple PET/MRI parameters, MTVMRI showed fair correlation with serum prostate-specific antigen (PSA; r = 0.442, p = 0.014) and highest correlation with tumor volume (r = 0.953, p < 0.001). UVPMRI showed highest correlation with serum PSA (r = 0.531, p = 0.003), good correlation with tumor volume (r = 0.908, p < 0.001), and it was significantly associated with Gleason score (p = 0.041). High MTVMRI and UVPMRI values were significant for perineural invasion, lymphatic invasion, extracapsular extension, seminal vesicle invasion, and positive B-cell lymphoma 2 (Bcl-2) expression (all p < 0.05).

Conclusion

Simultaneous 18F-FCH PET/MRI demonstrated a better diagnostic value for localized prostate cancer detection than each individual modality. MRI-assisted metabolic volumetric PET parameters (MTVMRI and UVPMRI) provided more accurate characterization of prostate cancer than conventional PET and MRI parameters.

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Acknowledgments

This study was supported by grants of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI07C0001 & HI14C1072).

Compliance with ethical standards

ᅟ

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea

    Yong-il Kim, Gi Jeong Cheon, Jin Chul Paeng, Keon Wook Kang, June-Key Chung & Dong Soo Lee

  2. Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea

    Yong-il Kim, Euishin Edmund Kim & Dong Soo Lee

  3. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Yong-il Kim, Gi Jeong Cheon, Keon Wook Kang & June-Key Chung

  4. Radiological Science Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Gi Jeong Cheon, Jeong Yeon Cho, Keon Wook Kang & June-Key Chung

  5. Department of Radiology, Seoul National University Hospital, Seoul, Korea

    Jeong Yeon Cho

  6. Department of Urology, Seoul National University Hospital, Seoul, Korea

    Cheol Kwak

  7. Department of Radiological Sciences, University of California, Irvine, CA, USA

    Euishin Edmund Kim

  8. Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, Korea

    Gi Jeong Cheon

  9. Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, Korea

    Jeong Yeon Cho

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  1. Yong-il Kim
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Correspondence to Gi Jeong Cheon or Jeong Yeon Cho.

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Kim, Yi., Cheon, G.J., Paeng, J.C. et al. Usefulness of MRI-assisted metabolic volumetric parameters provided by simultaneous 18F-fluorocholine PET/MRI for primary prostate cancer characterization. Eur J Nucl Med Mol Imaging 42, 1247–1256 (2015). https://doi.org/10.1007/s00259-015-3026-5

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  • DOI: https://doi.org/10.1007/s00259-015-3026-5

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