Dual-Phase PET-CT to Differentiate [18F]Fluoromethylcholine Uptake in Reactive and Malignant Lymph Nodes in Patients with Prostate Cancer

Daniela E. Oprea-Lager, Andrew D. Vincent, Reindert J A van Moorselaar, Winald R. Gerritsen, Alfons J M van den Eertwegh, Jonas Eriksson, Ronald Boellaard, Otto S. Hoekstra

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate whether time-trends of enhanced [18F]Fluoromethylcholine ([18F]FCH) in lymph nodes (LN) of prostate cancer (PCa) patients can help to discriminate reactive from malignant ones, and whether single time point standardized uptake value (SUV) measurements also suffice. Procedures: 25 PCa patients with inguinal (presumed benign) and enlarged pelvic LN (presumed malignant) showing enhanced [18F]FCH uptake at dual-phase PET-CT were analyzed. Associations between LN status (benign versus malignant) and SUVmax and SUVmeanA50, determined at 2 min (early) and 30 min (late) post injection, were assessed. We considered two time-trends of [18F]FCH uptake: type A (SUV early > SUV late) and type B (SUV late ≥ SUV early). Histopathology and/or follow-up were used to confirm the assumption that LN with type A pattern are benign, and LN with type B pattern malignant. Results: Analysis of 54 nodes showed that LN status, time-trends, and 'late' (30 min p.i.) SUVmax and SUVmeanA50 parameters were strongly associated (Pmax relative difference was the best LN status predictor. All but one inguinal LN showed a decreasing [18F]FCH uptake over time (pattern A), while 95% of the pelvic nodes presented a stable or increasing uptake (pattern B) type. Conclusions: Time-trends of enhanced [18F]FCH uptake can help to characterize lymph nodes in prostate cancer patients. Single time-point SUV measurements, 30 min p.i., may be a reasonable alternative for predicting benign versus malignant status of lymph nodes, but this remains to be validated in non-enlarged pelvic lymph nodes.

Original languageEnglish (US)
Article numbere48430
JournalPLoS One
Volume7
Issue number10
DOIs
StatePublished - Oct 31 2012
Externally publishedYes

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prostatic neoplasms
lymph nodes
Prostatic Neoplasms
Lymph Nodes
Groin
fluoromethylcholine
Positron Emission Tomography Computed Tomography
fluorocholine
histopathology
injection
Injections

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Oprea-Lager, D. E., Vincent, A. D., van Moorselaar, R. J. A., Gerritsen, W. R., van den Eertwegh, A. J. M., Eriksson, J., ... Hoekstra, O. S. (2012). Dual-Phase PET-CT to Differentiate [18F]Fluoromethylcholine Uptake in Reactive and Malignant Lymph Nodes in Patients with Prostate Cancer. PLoS One, 7(10), [e48430]. https://doi.org/10.1371/journal.pone.0048430

Dual-Phase PET-CT to Differentiate [18F]Fluoromethylcholine Uptake in Reactive and Malignant Lymph Nodes in Patients with Prostate Cancer. / Oprea-Lager, Daniela E.; Vincent, Andrew D.; van Moorselaar, Reindert J A; Gerritsen, Winald R.; van den Eertwegh, Alfons J M; Eriksson, Jonas; Boellaard, Ronald; Hoekstra, Otto S.

In: PLoS One, Vol. 7, No. 10, e48430, 31.10.2012.

Research output: Contribution to journalArticle

Oprea-Lager, DE, Vincent, AD, van Moorselaar, RJA, Gerritsen, WR, van den Eertwegh, AJM, Eriksson, J, Boellaard, R & Hoekstra, OS 2012, 'Dual-Phase PET-CT to Differentiate [18F]Fluoromethylcholine Uptake in Reactive and Malignant Lymph Nodes in Patients with Prostate Cancer', PLoS One, vol. 7, no. 10, e48430. https://doi.org/10.1371/journal.pone.0048430
Oprea-Lager DE, Vincent AD, van Moorselaar RJA, Gerritsen WR, van den Eertwegh AJM, Eriksson J et al. Dual-Phase PET-CT to Differentiate [18F]Fluoromethylcholine Uptake in Reactive and Malignant Lymph Nodes in Patients with Prostate Cancer. PLoS One. 2012 Oct 31;7(10). e48430. https://doi.org/10.1371/journal.pone.0048430
Oprea-Lager, Daniela E. ; Vincent, Andrew D. ; van Moorselaar, Reindert J A ; Gerritsen, Winald R. ; van den Eertwegh, Alfons J M ; Eriksson, Jonas ; Boellaard, Ronald ; Hoekstra, Otto S. / Dual-Phase PET-CT to Differentiate [18F]Fluoromethylcholine Uptake in Reactive and Malignant Lymph Nodes in Patients with Prostate Cancer. In: PLoS One. 2012 ; Vol. 7, No. 10.
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abstract = "Purpose: To investigate whether time-trends of enhanced [18F]Fluoromethylcholine ([18F]FCH) in lymph nodes (LN) of prostate cancer (PCa) patients can help to discriminate reactive from malignant ones, and whether single time point standardized uptake value (SUV) measurements also suffice. Procedures: 25 PCa patients with inguinal (presumed benign) and enlarged pelvic LN (presumed malignant) showing enhanced [18F]FCH uptake at dual-phase PET-CT were analyzed. Associations between LN status (benign versus malignant) and SUVmax and SUVmeanA50, determined at 2 min (early) and 30 min (late) post injection, were assessed. We considered two time-trends of [18F]FCH uptake: type A (SUV early > SUV late) and type B (SUV late ≥ SUV early). Histopathology and/or follow-up were used to confirm the assumption that LN with type A pattern are benign, and LN with type B pattern malignant. Results: Analysis of 54 nodes showed that LN status, time-trends, and 'late' (30 min p.i.) SUVmax and SUVmeanA50 parameters were strongly associated (Pmax relative difference was the best LN status predictor. All but one inguinal LN showed a decreasing [18F]FCH uptake over time (pattern A), while 95{\%} of the pelvic nodes presented a stable or increasing uptake (pattern B) type. Conclusions: Time-trends of enhanced [18F]FCH uptake can help to characterize lymph nodes in prostate cancer patients. Single time-point SUV measurements, 30 min p.i., may be a reasonable alternative for predicting benign versus malignant status of lymph nodes, but this remains to be validated in non-enlarged pelvic lymph nodes.",
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AU - Gerritsen, Winald R.

AU - van den Eertwegh, Alfons J M

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