Introducing Parametric Fusion PET/MRI of Primary Prostate Cancer

Overview

Journal J Nucl Med

Specialty Nuclear Medicine

Date 2012 Mar 16

PMID 22419751

Citations 29

Authors

Hyunjin Park

David Wood

Hero Hussain

Charles R Meyer

Rajal B Shah

Timothy D Johnson

Thomas Chenevert

Morand Piert

Affiliations

Soon will be listed here.

Abstract

Unlabelled: We assessed the performance of parametric fusion PET/MRI based on (11)C-choline PET/CT and apparent diffusion coefficient (ADC) maps derived from diffusion-weighted MRI for the identification of primary prostate cancer.

Methods: (11)C-choline PET/CT and MRI were performed in 17 patients with untreated primary prostate cancer, followed by prostatectomy. Registration of in vivo imaging with histology was achieved using a mutual-information objective function and by performing ex vivo MRI of the prostatectomy specimen (obtained at 3 T) and whole-mount sectioning with block-face photography as intermediate steps. Data analysis included volumetrically registered whole-mount histology with Gleason scoring, (11)C-choline, and ADC data (obtained at 1.5 T). Volumes of interest were defined on the basis of histologically proven tumor tissue to calculate tumor-to-benign prostate background ratios (TBRs) for (11)C-choline, ADC, and a derived fusion PET/MRI parameter calculating the quotient of (11)C-choline over ADC (P(CHOL/ADC)).

Results: Fifty-one tumor nodules were identified at pathology. The TBRs for (11)C-choline (P < 0.05) and P(CHOL/ADC) (P < 0.005) were significantly higher in prostate cancers with a Gleason score of ≥3 + 4 than with a Gleason score of ≤3 + 3 disease and controls. For Gleason ≥ 3 + 4, the ADC TBRs were significantly lower than controls and Gleason ≤ 3 + 3 disease (P < 0.05). The absolute value of TBRs obtained from Gleason ≥ 3 + 4 cancers increased from ADC to (11)C-choline PET/CT and from (11)C-choline PET/CT to P(CHOL/ADC), with each step being statistically significant.

Conclusion: Our data indicate that parametric PET/MRI using P(CHOL/ADC) improves lesion-to-background contrast (TBRs) of Gleason ≥ 3 + 4 disease, compared with (11)C-choline PET/CT or diffusion-weighted MRI, and thus hold promise that parametric imaging performed on hybrid PET/MRI may further improve identification and localization of significant primary prostate cancer.

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