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Title: Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases

Abstract

Purpose: To determine the clinical value of two novel molecular imaging techniques: {sup 11}C-choline positron emission tomography (PET)/computed tomography (CT) and ferumoxtran-10 enhanced magnetic resonance imaging (magnetic resonance lymphography [MRL]) for lymph node (LN) treatment in prostate cancer (PCa) patients. Therefore, we evaluated the ability of PET/CT and MRL to assess the number, size, and location of LN metastases in patients with primary or recurrent PCa. Methods and Materials: A total of 29 patients underwent MRL and PET/CT for LN evaluation. The MRL and PET/CT data were analyzed independently. The number, size, and location of the LN metastases were determined. The location was described as within or outside the standard clinical target volume for elective pelvic irradiation as defined by the Radiation Therapy Oncology Group. Subsequently, the results from MRL and PET/CT were compared. Results: Of the 738 LNs visible on MRL, 151 were positive in 23 of 29 patients. Of the 132 LNs visible on PET/CT, 34 were positive in 13 of 29 patients. MRL detected significantly more positive LNs (p < 0.001) in more patients than PET/CT (p = 0.002). The mean diameter of the detected suspicious LNs on MRL was significantly smaller than those detected by PET/CT,more » 4.9 mm and 8.4 mm, respectively (p < 0.0001). In 14 (61%) of 23 patients, suspicious LNs were found outside the clinical target volume with MRL and in 4 (31%) of 13 patients with PET/CT. Conclusion: In patients with PCa, both molecular imaging techniques, MRL and {sup 11}C-choline PET/CT, can detect LNs suspicious for metastasis, irrespective of the existing size and shape criteria for CT and conventional magnetic resonance imaging. On MRL and PET/CT, 61% and 31% of the suspicious LNs were located outside the conventional clinical target volume. Therefore, these techniques could help to individualize treatment selection and enable image-guided radiotherapy for patients with PCa LN metastases.« less

Authors:
 [1];  [1];  [2];  [3]; ;  [1]; ;  [4];  [5]; ;  [6];  [1];  [2];  [1]
  1. Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
  2. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
  3. Department of Radiology, Jeroen Bosch Hospital's, Hertogenbosch (Netherlands)
  4. Department of Nuclear Medicine, University of Ulm, Ulm (Germany)
  5. Department of Nuclear Medicine, Technische Universitaet Muenchen, Muenchen (Germany)
  6. Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
Publication Date:
OSTI Identifier:
22149577
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARBON 11; CHOLINE; IRON OXIDES; IRRADIATION; LYMPH NODES; MAGNETIC RESONANCE; METASTASES; NANOSTRUCTURES; NEOPLASMS; NMR IMAGING; PARAMAGNETISM; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; PROSTATE; RADIOTHERAPY; STANDARDS

Citation Formats

Fortuin, Ansje S., E-mail: A.Fortuin@rad.umcn.nl, Deserno, Willem M.L.L.G., Meijer, Hanneke J.M., Jager, Gerrit J., Takahashi, Satoru, Debats, Oscar A., Reske, Sven N., Schick, Christian, Krause, Bernd J., Oort, Inge van, Witjes, Alfred J., Hoogeveen, Yvonne L., Lin, Emile N.J.Th. van, and Barentsz, Jelle O. Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.093.
Fortuin, Ansje S., E-mail: A.Fortuin@rad.umcn.nl, Deserno, Willem M.L.L.G., Meijer, Hanneke J.M., Jager, Gerrit J., Takahashi, Satoru, Debats, Oscar A., Reske, Sven N., Schick, Christian, Krause, Bernd J., Oort, Inge van, Witjes, Alfred J., Hoogeveen, Yvonne L., Lin, Emile N.J.Th. van, & Barentsz, Jelle O. Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases. United States. doi:10.1016/J.IJROBP.2011.12.093.
Fortuin, Ansje S., E-mail: A.Fortuin@rad.umcn.nl, Deserno, Willem M.L.L.G., Meijer, Hanneke J.M., Jager, Gerrit J., Takahashi, Satoru, Debats, Oscar A., Reske, Sven N., Schick, Christian, Krause, Bernd J., Oort, Inge van, Witjes, Alfred J., Hoogeveen, Yvonne L., Lin, Emile N.J.Th. van, and Barentsz, Jelle O. Thu . "Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases". United States. doi:10.1016/J.IJROBP.2011.12.093.
@article{osti_22149577,
title = {Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases},
author = {Fortuin, Ansje S., E-mail: A.Fortuin@rad.umcn.nl and Deserno, Willem M.L.L.G. and Meijer, Hanneke J.M. and Jager, Gerrit J. and Takahashi, Satoru and Debats, Oscar A. and Reske, Sven N. and Schick, Christian and Krause, Bernd J. and Oort, Inge van and Witjes, Alfred J. and Hoogeveen, Yvonne L. and Lin, Emile N.J.Th. van and Barentsz, Jelle O.},
abstractNote = {Purpose: To determine the clinical value of two novel molecular imaging techniques: {sup 11}C-choline positron emission tomography (PET)/computed tomography (CT) and ferumoxtran-10 enhanced magnetic resonance imaging (magnetic resonance lymphography [MRL]) for lymph node (LN) treatment in prostate cancer (PCa) patients. Therefore, we evaluated the ability of PET/CT and MRL to assess the number, size, and location of LN metastases in patients with primary or recurrent PCa. Methods and Materials: A total of 29 patients underwent MRL and PET/CT for LN evaluation. The MRL and PET/CT data were analyzed independently. The number, size, and location of the LN metastases were determined. The location was described as within or outside the standard clinical target volume for elective pelvic irradiation as defined by the Radiation Therapy Oncology Group. Subsequently, the results from MRL and PET/CT were compared. Results: Of the 738 LNs visible on MRL, 151 were positive in 23 of 29 patients. Of the 132 LNs visible on PET/CT, 34 were positive in 13 of 29 patients. MRL detected significantly more positive LNs (p < 0.001) in more patients than PET/CT (p = 0.002). The mean diameter of the detected suspicious LNs on MRL was significantly smaller than those detected by PET/CT, 4.9 mm and 8.4 mm, respectively (p < 0.0001). In 14 (61%) of 23 patients, suspicious LNs were found outside the clinical target volume with MRL and in 4 (31%) of 13 patients with PET/CT. Conclusion: In patients with PCa, both molecular imaging techniques, MRL and {sup 11}C-choline PET/CT, can detect LNs suspicious for metastasis, irrespective of the existing size and shape criteria for CT and conventional magnetic resonance imaging. On MRL and PET/CT, 61% and 31% of the suspicious LNs were located outside the conventional clinical target volume. Therefore, these techniques could help to individualize treatment selection and enable image-guided radiotherapy for patients with PCa LN metastases.},
doi = {10.1016/J.IJROBP.2011.12.093},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}