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Incidental Abnormal FDG Uptake in the Prostate on 18-fluoro-2-Deoxyglucose Positron Emission Tomography-Computed Tomography Scans

  • Kang, Pil Moon ;
  • Seo, Won Ik ;
  • Lee, Sun Seong ;
  • Bae, Sang Kyun ;
  • Kwak, Ho Sup ;
  • Min, Kweonsik ;
  • Kim, Wansuk ;
  • Kang, Dong Il
  • Published : 2014.11.06

Abstract

18-fluoro-2-deoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET/CT) scans are commonly used for the staging and restaging of various malignancies, such as head and neck, breast, colorectal and gynecological cancers. However, the value of FDG PET/CT for detecting prostate cancer is unknown. The aim of this study was to evaluate the clinical value of incidental prostate $^{18}F$-FDG uptake on PET/CT scans. We reviewed $^{18}F$-FDG PET/CT scan reports from September 2009 to September 2013, and selected cases that reported focal/diffuse FDG uptake in the prostate. We analyzed the correlation between $^{18}F$-FDG PET/CT scan findings and data collected during evaluations such as serum prostate-specific antigen (PSA) levels, digital rectal examination (DRE), transrectal ultrasound (TRUS), and/or biopsy to confirm prostate cancer. Of a total of 18,393 cases, 106 (0.6%) exhibited abnormal hypermetabolism in the prostate. Additional evaluations were performed in 66 patients. Serum PSA levels were not significantly correlated with maximum standardized uptake values (SUVmax) in all patients (rho 0.483, p=0.132). Prostate biopsies were performed in 15 patients, and prostate cancer was confirmed in 11. The median serum PSA level was 4.8 (0.55-7.06) ng/mL and 127.4 (1.06-495) ng/mL in the benign and prostate cancer groups, respectively. The median SUVmax was higher in the prostate cancer group (mean 10.1, range 3.8-24.5) than in the benign group (mean 4.3, range 3.1-8.8), but the difference was not statistically significant (p=0.078). There was no significant correlation between SUVmax and serum PSA, prostatic volume, or Gleason score. $^{18}F$-FDG PET/CT scans did not reliably differentiate malignant or benign from abnormal uptake lesions in the prostate, and routine prostate biopsy was not usually recommended in patients with abnormal FDG uptake. Nevertheless, patients with incidental prostate uptake on $^{18}F$-FDG PET/CT scans should not be ignored and should be undergo further clinical evaluations, such as PSA and DRE.

Keywords

Prostate cancer;positron emission tomography/computed tomography;prostate

References

  1. Godoy A, Ulloa V, Rodriguez F, et al (2006). Differential subcellular distribution of glucose transporters GLUT1-6 and GLUT9 in human cancer: ultrastructural localization of GLUT1 and GLUT5 in breast tumor tissues. J Cell Physiol, 207, 614-27. https://doi.org/10.1002/jcp.20606
  2. Bouchelouche K, Oehr P (2008). Positron emission tomography and positron emission tomography/computerized tomography of urological malignancies: an update review. J Urol, 179, 34-45.
  3. Effert P, Beniers AJ, Tamimi Y, et al (2004). Expression of glucose transporter 1 (Glut-1) in cell lines and clinical specimens from human prostate adenocarcinoma. Anticancer Res, 24, 3057-63.
  4. Effert PJ, Bares R, Handt S, et al (1996). Metabolic imaging of untreated prostate cancer by positron emission tomography with 18fluorine-labeled deoxyglucose. J Urol, 155, 994-8. https://doi.org/10.1016/S0022-5347(01)66366-3
  5. Han EJ, H OJ, Choi WH, et al (2010). Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images. Br J Radiol, 83, 915-20. https://doi.org/10.1259/bjr/19887771
  6. Hasbek Z, Yucel B, Salk I, et al (2014). Potential impact of atelectasis and primary tumor glycolysis on F-18 FDG PET/CT on survival in lung cancer patients. Asian Pac J Cancer Prev, 15, 4085-9. https://doi.org/10.7314/APJCP.2014.15.9.4085
  7. Hofer C, Laubenbacher C, Block T, et al (1999). Fluorine-18-fluorodeoxyglucose positron emission tomography is useless for the detection of local recurrence after radical prostatectomy. Eur Urol, 36, 31-5.
  8. Lawrentschuk N, Davis ID, Bolton DM, et al (2006). Positron emission tomography and molecular imaging of the prostate: an update. BJU Int, 97, 923-31. https://doi.org/10.1111/j.1464-410X.2006.06040.x
  9. Hoh CK, Seltzer MA, Franklin J, et al (1998). Positron emission tomography in urological oncology. J Urol, 159, 347-56. https://doi.org/10.1016/S0022-5347(01)63916-8
  10. Hwang I, Chong A, Jung SI, et al (2013). Is further evaluation needed for incidental focal uptake in the prostate in 18-fluoro-2-deoxyglucose positron emission tomographycomputed tomography images? Ann Nucl Med, 27, 140-5. https://doi.org/10.1007/s12149-012-0663-7
  11. Kao PF, Chou YH, Lai CW (2008). Diffuse FDG uptake in acute prostatitis. Clin Nucl Med, 33, 308-10. https://doi.org/10.1097/RLU.0b013e3181662f8b
  12. Levi J, Cheng Z, Gheysens O, et al (2007). Fluorescent fructose derivatives for imaging breast cancer cells. Bioconjug Chem, 18, 628-34. https://doi.org/10.1021/bc060184s
  13. Minamimoto R, Uemura H, Sano F, et al (2011). The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level. Ann Nucl Med, 25, 21-7. https://doi.org/10.1007/s12149-010-0424-4
  14. Oyama N, Akino H, Suzuki Y, et al (1999). The increased accumulation of [18F]fluorodeoxyglucose in untreated prostate cancer. Jpn J Clin Oncol, 29, 623-9. https://doi.org/10.1093/jjco/29.12.623
  15. Piccardo A, Paparo F, Picazzo R, et al (2014). Value of fused (18) F-choline-PET/MRI to evaluate prostate cancer relapse in patients showing biochemical recurrence after ebrt: preliminary results. Biomed Res Int, 2014, 103718.
  16. Picchio M, Berardi G, Fodor A, et al (2014). (11)C-Choline PET/CT as a guide to radiation treatment planning of lymph-node relapses in prostate cancer patients. Eur J Nucl Med Mol Imaging, 41, 1270-9.
  17. Powles T, Murray I, Brock C, et al (2007). Molecular positron emission tomography and PET/CT imaging in urological malignancies. Eur Urol, 51, 1511-20; discussion 20-1. https://doi.org/10.1016/j.eururo.2007.01.061
  18. Zhao JY, Ma XL, Li YY, et al (2014). Diagnostic Accuracy of 18F-FDG-PET in patients with testicular cancer: a metaanalysis. Asian Pac J Cancer Prev, 15, 3525-31. https://doi.org/10.7314/APJCP.2014.15.8.3525
  19. Reinicke K, Sotomayor P, Cisterna P, et al (2012). Cellular distribution of Glut-1 and Glut-5 in benign and malignant human prostate tissue. J Cell Biochem, 113, 553-62. https://doi.org/10.1002/jcb.23379
  20. Scher B, Seitz M, Albinger W, et al (2007). Value of 11C-choline PET and PET/CT in patients with suspected prostate cancer. Eur J Nucl Med Mol Imaging, 34, 45-53. https://doi.org/10.1007/s00259-006-0190-7
  21. Shiiba M, Ishihara K, Kimura G, et al (2012). Evaluation of primary prostate cancer using 11C-methionine-PET/CT and 18F-FDG-PET/CT. Ann Nucl Med, 26, 138-45. https://doi.org/10.1007/s12149-011-0551-6

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Acknowledgement

Supported by : Inje University Busan Paik Hospital