Impact of sodium 18F-fluoride PET/CT, 18F-fluorocholine PET/CT and whole-body diffusion-weighted MRI on the management of patients with prostate cancer suspicious for metastasis: a prospective multicentre study

Gauthé, Mathieu;Aveline, Cyrielle;Lecouvet, Frédéric;Michaud, Laure;Durand-Zaleski, Isabelle;et.al.
(2019) World Journal of Urology — Vol. 37, n° 8, p. 1587-1595 (2019)

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  • Gauthé, Mathieu
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  • Aveline, Cyrielle
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  • Lecouvet, FrédéricUCLouvain
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  • Michaud, Laure
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  • Durand-Zaleski, Isabelle
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Abstract
PURPOSE: To compare the impact of 18F-sodium-fluoride (NaF) PET/CT, 18F-fluorocholine (FCH) PET/CT and diffusion-weighted whole-body MRI (DW-MRI) on the management of patients with prostate cancer (PCa) suspicious for distant metastasis. METHODS: Prostate cancer patients were prospectively included between December 2011 and August 2014 and benefited from these three whole-body imaging (WBI) modalities within 1 month in addition to the standard PCa workup. Management was prospectively decided by clinicians during two multidisciplinary meetings, before and after the whole-body imaging workup. Rates of induced changes of whole-body imaging modalities were compared by Cochran's Q test. RESULTS: One-hundred-one patients (27 at staging, 59 at first biochemical recurrence (BCR) and 15 at first episode of rising serum level of prostate-specific antigen during androgen-deprivation therapy) were included. The overall rate of management changes was 52%: 29% as a consequence of WBI, higher for FCH-PET/CT than for NaF-PET/CT or DW-MRI (p < 0.0001) and highest (41%) for FCH-PET/CT at BCR. Actual management was adequate in all patients but two. CONCLUSIONS: Whole-body imaging induced a change in management in approximately a third of PCa patients suspicious for metastasis. The impact rate was determined to be greatest at first BCR using FCH-PET/CT. NaF-PET/CT and DW-MRI seemed less useful in this context.
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Gauthé, M., Aveline, C., Lecouvet, F., Michaud, L., Rousseau, C., Tassart, M., Cussenot, O., Talbot, J.-N., & Durand-Zaleski, I. (2019). Impact of sodium 18F-fluoride PET/CT, 18F-fluorocholine PET/CT and whole-body diffusion-weighted MRI on the management of patients with prostate cancer suspicious for metastasis: a prospective multicentre study. World Journal of Urology, 37(8), 1587-1595. https://doi.org/10.1007/s00345-018-2547-5 (Original work published 2019)