Preoperative detection of prostate cancer: A comparison with ¹¹C-choline PET, ¹⁸F-fluorodeoxyglucose PET and MR imaging

Abstract

Purpose: To compare 11C-choline positron emission tomography (C-PET), 18F-fluorodeoxyglucose PET (FDG-PET), and MR imaging in the preoperative detection of prostate cancer. Materials and Methods: C-PET, FDG-PET, and MR images were obtained in 43 consecutive patients with suspected prostate cancer, and prostate cancers were histopathologically confirmed in 26 patients. Unenhanced T1-weighted, T2-weighted, and gadolinium-enhanced MR images were obtained. C-PET and FDG-PET were conducted 1.5 and 60 minutes after injection of 5.5 and 5.0 MBq/kg tracers, respectively. A nuclear and a genitourinary radiologist retrospectively reviewed PET and MR images at random, respectively, and assigned a confidence level for the presence of prostate cancer using a four-point scale. Diagnostic performance was tested using the McNemar test and receiver operating characteristic curve analysis. Results: The sensitivity was greater (P < 0.05) with MR (88%) and C-PET (73%) images than with FDG-PET images (31%). The accuracy was greater (P < 0.05) with MR images (88%) than with C-PET (67%) and FDG-PET (53%) images. The area-under-curve value with MR (0.90) was greater than those with C-PET (0.53) and FDG-PET (0.54) images (P < 0.01). Conclusion: MR imaging should be primarily performed in the preoperative detection of prostate cancer. C-PET and FDG-PET did not improve the detection. © 2010 Wiley-Liss, Inc.