Pd37-05 Histologic Validation of 11carbon-acetate Positron Emission Tomography/computer Tomography in Detecting Lymph Node Metastases in Prostate Cancer
Year: 2018
Type: article
Abstract: You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2018PD37-05 HISTOLOGIC VALIDATION OF 11CARBON-ACETATE POSITRON EMISSION TOMOGRAPHY/COMPUTER TOMOGRAPHY IN DETECTING LYMPH NODE METASTASES IN PROSTATE CANCER Nieroshan Rajarubendra, Zarko Manojlovic, Chisato Ohe, Nariman Ahmadi, Giovanni Cacciamani, Michael Qiu, Andre Abreu, Jie Ca, Gus Miranda, John Carpten, Manju Aron, Fabio Almeida, and Inderbir S. Gill Nieroshan RajarubendraNieroshan Rajarubendra More articles by this author , Zarko ManojlovicZarko Manojlovic More articles by this author , Chisato OheChisato Ohe More articles by this author , Nariman AhmadiNariman Ahmadi More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Michael QiuMichael Qiu More articles by this author , Andre AbreuAndre Abreu More articles by this author , Jie CaJie Ca More articles by this author , Gus MirandaGus Miranda More articles by this author , John CarptenJohn Carpten More articles by this author , Manju AronManju Aron More articles by this author , Fabio AlmeidaFabio Almeida More articles by this author , and Inderbir S. GillInderbir S. Gill More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1740AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conventional imaging modalities are inadequate to definitively detect nodal metastases from prostate cancer (PCa). We evaluated 11-carbon-Acetate (11C-Acetate) PET/CT for identifying nodal metastases, examining PCa factors influencing detection rates. METHODS Patients with 11C-Acetate avid pelvic/retroperitoneal lymph nodes underwent high-extended robotic lymphadenectomy. A standardized anatomical mapping-template, comprising 8 pre-determined regions, was dissected during lymphadenectomy, allowing for matched comparison of imaging and histological data. Region-based analysis was performed. RESULTS In 25 patients, total 2149 lymph nodes were excised (mean 86 nodes/patient [27-136]), wherein 528 (22%) harbored metastases (mean 21 positive nodes/patient [0-109]). In total, 177 regions had matching imaging-histologic data. 11C-Acetate imaging correctly identified total 48 positive nodal regions, while accurately ruling-out 88 regions as metastasis-free. 11C-Acetate sensitivity, specificity, PPV and NPV were 66.7%, 83.8%, 73.9% and 78.6% respectively. Median Standard Uptake Value (SUV) for true-positive result was 3.2. Increasing histologically-measured metastatic-lesion size in long axis diameter (LAD) (=5mm, 6-10mm, 11-15mm, 16-20mm and =21mm) correlated with improved 11C-Acetate detection rates (45%, 61.9%, 81.3%, 88.9% and 100%, respectively). After controlling for template level, laterality, pre-PET PSA and Gleason score, each SUV unit increase correlated with an increase of 1.9mm in LAD (p<0.001) and 1.2mm in short axis diameter(SAD) of the node (p<0.001). Histologic lymphnode size (LAD 12.0mm, SAD 6.0mm) and metastatic-lesion size (LAD 11.0mm, SAD 6.0mm) correlated with positive 11C-Acetate scan, as did extra-nodal extension (true-positive 87.5% vs false-negative 58% [p=0.0045]). CONCLUSIONS 11C-Acetate scanning can identify metastatic nodal disease, performing better in the pelvis than the retroperitoneum. It under-estimates the true cephalad extent of nodal involvement. Factors such as SUV, histological nodal and intra-nodal metastasis size, and extra-nodal extension increase likelihood of identifying cancer-bearing nodes. Larger studies with histologic correlation are required to confirm accuracy, thereby to better guide surgical lymphadenectomy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e732-e733 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nieroshan Rajarubendra More articles by this author Zarko Manojlovic More articles by this author Chisato Ohe More articles by this author Nariman Ahmadi More articles by this author Giovanni Cacciamani More articles by this author Michael Qiu More articles by this author Andre Abreu More articles by this author Jie Ca More articles by this author Gus Miranda More articles by this author John Carpten More articles by this author Manju Aron More articles by this author Fabio Almeida More articles by this author Inderbir S. Gill More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Authors: Nieroshan Rajarubendra, Zarko Manojlovic, Chisato Ohe, Nariman Ahmadi, Giovanni Cacciamani, Michael Qiu, Andre Abreu, Jie Ca, Gus Miranda, John Carpten, Manju Aron, Fabio Almeida, Inderbir S. Gill
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4243370017