caa a22 4500 605494916 CHVBK 20210128100528.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0520-y doi (NATIONALLICENCE)springer-10.1007/s00261-015-0520-y Does focal incidental 18F-FDG PET/CT uptake in the prostate have significance? [Elektronische Daten] [Anna Brown, Maria Lindenberg, Sandeep Sankineni, Joanna Shih, Linda Johnson, Suneha Pruthy, Karen Kurdziel, Maria Merino, Bradford Wood, Peter Pinto, Peter Choyke, Baris Turkbey] Purpose: 18F-FDG PET/CT is used to characterize many malignancies, but is not recommended for localized prostate cancer. This study explores the value of multi-parametric MRI (mpMRI) in characterizing incidental prostate 18F-FDG uptake. Methods: Thirty-one patients who underwent 18F-FDG PET/CT for reasons unrelated to prostate cancer and prostate mpMRI were eligible for this retrospective study. The mpMRI included T2-weighted (T2W), dynamic contrast enhancement (DCE), apparent diffusion coefficient (ADC), and MR spectroscopy (MRS) sequences. Fourteen patients were excluded (n=8 insufficient histopathology, n=6 radical prostatectomy before PET), and final analysis included 17 patients. A nuclear medicine physician, blinded to clinicopathologic findings, identified suspicious areas and maximum standardized uptake values (SUVmax) on 18F-FDG PET/CT. Sector-based imaging findings were correlated with annotated histopathology from whole-mount or MRI/transrectal ultrasound fusion biopsy samples. Positive predictive values (PPVs) were estimated using generalized estimating equations with logit link. Results were evaluated with Kruskal-Wallis and Dunn's multiple comparisons tests. Results: The PPV of 18F-FDG PET alone in detecting prostate cancer was 0.65. Combining 18F-FDG PET as a base parameter with mpMRI (T2W, DCE, ADC, and MRS) increased the PPV to 0.82, 0.83, 0.83, and 0.94, respectively. All benign lesions had SUVmax<6. Malignant lesions had higher SUVmax values that correlated with Gleason scores. There was a significant difference in SUVmax per prostate between the Gleason≥4+5 and benign categories (p=0.03). Conclusions: Focal incidental prostate 18F-FDG uptake has low clinical utility alone, but regions of uptake may harbor high-grade prostate cancer, especially if SUVmax>6. Using mpMRI to further evaluate incidental 18F-FDG uptake aids the diagnosis of prostate cancer. Springer Science+Business Media New York, 2015 18F-FDG PET nationallicence Prostate cancer nationallicence Multi-parametric MRI nationallicence Incidental FDG uptake nationallicence Brown Anna Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Lindenberg Maria Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Sankineni Sandeep Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Shih Joanna Biometric Research Branch, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, MD, USA aut Johnson Linda Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Pruthy Suneha Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Kurdziel Karen Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Merino Maria Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA aut Wood Bradford Center for Interventional Oncology, NCI, NIH, Bethesda, MD, USA aut Pinto Peter Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut Choyke Peter Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Turkbey Baris Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3222-3229 0942-8925 40:8<3222 2015 40 261 https://doi.org/10.1007/s00261-015-0520-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0520-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Brown Anna Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Lindenberg Maria Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Sankineni Sandeep Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Shih Joanna Biometric Research Branch, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Johnson Linda Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Pruthy Suneha Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Kurdziel Karen Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Merino Maria Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Wood Bradford Center for Interventional Oncology, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Pinto Peter Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Choyke Peter Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Turkbey Baris Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive, Room B3B85, 20892, Bethesda, MD, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3222-3229 0942-8925 40:8<3222 2015 40 261