Fluorodeoxyglucose positron emission tomography studies in the diagnosis and staging of clinically advanced prostate cancer

• Published in: BJU international 2003-07, Vol.92 (1), p.24-27
• Main Authors: Sung, J., Espiritu, J.I., Segall, G.M., Terris, M.K.
• Format: Article
• Language: English
• Subjects: Abdominal Neoplasms - diagnostic imaging; Abdominal Neoplasms - secondary; Aged; Biological and medical sciences; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - secondary; Fluorodeoxyglucose F18; Humans; imaging; Male; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasm Staging - methods; Nephrology. Urinary tract diseases; Pelvic Neoplasms - diagnostic imaging; Pelvic Neoplasms - secondary; PET; Prostate-Specific Antigen - blood; prostatic neoplasms; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Radiopharmaceuticals; staging; tomography; Tomography, Emission-Computed - methods; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1046/j.1464-410X.2003.04297.x

OBJECTIVE To determine the value of 18F‐fluoro‐2‐deoxyglucose (FDG) positron‐emission tomography (PET) studies in evaluating patients with advanced prostate cancer. PATIENTS AND METHODS FDG‐PET scans were taken in 30 patients with advanced prostate cancer 1 h after an injection with 555 MBq of FDG. Patients were scanned from the base of the skull to the inguinal region (including the pelvis). They were also assessed by computed tomography (CT) of the abdomen and pelvis, and bone scintigraphy, to evaluate them for metastases. RESULTS Thirteen patients had locally extensive prostate cancer and 17 had metastatic disease. Twenty of the 30 patients were positive for radioisotope uptake in the prostate or extraprostatically. The patients with PET‐detected prostate cancer were untreated (seven), treated hormonally while they had rising PSA levels (eight), or treated hormonally with a detectable but stable PSA (five). The remaining 10 patients were negative for FDG uptake in the prostate or any metastatic sites; these 10 patients were receiving hormone therapy, with undetectable PSA levels. CONCLUSION FDG‐PET imaging is not a useful test in evaluating advanced prostate cancer in patients being treated and who have an undetectable PSA level. Staging of advanced prostate cancer may be enhanced by FDG‐PET imaging in patients who are untreated, who have had an incomplete response to therapy, or who have a rising PSA level despite treatment.