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Potential of hybrid 18F-fluorocholine PET/MRI for prostate cancer imaging

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

Abstract

Purpose

To report the first results of hybrid 18F-fluorocholine PET/MRI imaging for the detection of prostate cancer.

Methods

This analysis included 26 consecutive patients scheduled for prostate PET/MRI before radical prostatectomy. The examinations were performed on a hybrid whole-body PET/MRI scanner. The MR acquisitions which included T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences were followed during the same session by whole-body PET scans. Parametric maps were constructed to measure normalized T2-weighted intensity (nT2), apparent diffusion coefficient (ADC), volume transfer constant (K trans), extravascular extracellular volume fraction (v e) and standardized uptake values (SUV). With pathology as the gold standard, ROC curves were calculated using logistic regression for each parameter and for the best combination with and without PET to obtain a MR model versus a PETMR model.

Results

Of the 26 patients initially selected, 3 were excluded due to absence of an endorectal coil (2 patients) or prosthesis artefacts (1 patient). In the whole prostate, the area under the curve (AUC) for SUVmax, ADC, nT2, K trans and v e were 0.762, 0.756, 0.685, 0.611 and 0.529 with a best threshold at 3.044 for SUVmax and 1.075 × 10−3 mm2/s for ADC. The anatomical distinction between the transition zone and the peripheral zone showed the potential of the adjunctive use of PET. In the peripheral zone, the AUC of 0.893 for the PETMR model was significantly greater (p = 0.0402) than the AUC of 0.84 for the MR model only. In the whole prostate, no relevant correlation was observed between ADC and SUVmax. The SUVmax was not affected by the Gleason score.

Conclusion

The performance of a hybrid whole-body 18F-fluorocholine PET/MRI scan in the same session combined with a prostatic MR examination did not interfere with the diagnostic accuracy of the MR sequences. The registration of the PET data and the T2 anatomical MR sequence data allowed precise localization of hypermetabolic foci in the prostate. While in the transition zone the adenomatous hyperplasia interfered with cancer detection by PET, the quantitative analysis tool performed well for cancer detection in the peripheral zone.

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Authors and Affiliations

  1. Division of Radiology, Geneva University Hospitals and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Genève 14, Switzerland

    Thomas de Perrot, Max Scheffler & Jean-Paul Vallee

  2. Division of Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland

    Olivier Rager & Osman Ratib

  3. Division of Nuclear Medicine, University of Montreal Hospital Center, Montréal, Canada

    Martin Lord

  4. Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland

    Marc Pusztaszeri

  5. Division of Urologic Surgery, Geneva University Hospitals, Geneva, Switzerland

    Christophe Iselin

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  1. Thomas de Perrot
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Correspondence to Thomas de Perrot.

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Thomas de Perrot and Olivier Rager contributed equally to this work.

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de Perrot, T., Rager, O., Scheffler, M. et al. Potential of hybrid 18F-fluorocholine PET/MRI for prostate cancer imaging. Eur J Nucl Med Mol Imaging 41, 1744–1755 (2014). https://doi.org/10.1007/s00259-014-2786-7

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  • DOI: https://doi.org/10.1007/s00259-014-2786-7

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