The Application Of ¹¹C-Choline PET/MRI In Prostate Cancer

Objectives:1. To evaluate the value of SUVmax/ADCmin in the differential diagnosis of benign and malignant prostate disease.2. To explore the application value of multi-parameter 11C-Choline PET/MRI in the diagnosis of benign and malignant lesions of prostate.Methods:1. Suspicious prostate cancer patients who underwent PET/MR before prostate systematic biopsy in perineal approach in PLA general hospital from April 2014 to January 2015 were observed. Prostate gland was divided into five districts, and in every district a 1 cm in diameter was drawn at the most radioactivity concentration and/or lowest ADC signal area, SUVmax, ADCmin and SUVmax/ADCmin were calculated. Taking the biopsy pathology results as "gold standard", malignant and benign prostate disease districts were separated. Pearson correlation analysis and two-sample t test were used for statistical analysis.2. Retrospective analyzed 48 patients'11C-Choline PET/MR imaging and clinical data in PLA general hospital from April 2014 to January 2016. Make the pathological result achieved and untreated patients as the research object, MR images and PET/MRI fusion images were read by two experienced nuclear medicine physician blinded to the pathological result. Then take the biopsy pathology results as gold standard, to evaluate the diagnostic efficiency. Pearson correlation analysis were used between the prostate cancer patients' PSA and SUVmax, ADCmin, SUVmax/ADCmin respectivelyResults:1. A total of 15 patients (75 districts) were confirmed by biopsy pathology as 50 benign prostate disease districts and 25 prostate cancer districts. SUVmax had a negative correlation with ADCmin (r=-0.521, P<0.05). The difference of SUVmax/ADCmin between benign and malignant districts was significant (5.67±3.03 and 13.76±7.13; t=6.9, P<0.01). The ROC AUC for ADCmin, SUVmax and SUVmax/ADCmin were 0.880,0.809 and 0.898. Using SUVmax/ADCmin of 7.78 as criterion, the sensitivity and specificity were 84.0% and 86.0%.2. A group of 27 patients were confirmed by pathology as 10 benign prostate disease patients and 17 prostate cancer patients. 11C-Choline PET/MRI'diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value, is 100%,90%,96.29%, 99.44%,100% respectively in the 27 patients.12 suspicious prostate cancer patients were diagnosed by MRI, pathology confined them as 6 cases of benign and 6 cases of malignant prostate disease. "C-Choline PET/MRI gave the same diagnosis as pathology results for these 12 patients. There is no relationship between the prostate cancer patients'PSA and SUVmax, ADCmin, SUVmax/ADCmin (r=0.187, p=0.473; r=-0.026, p=0.923; r=0.064, p=0.806).Conclusions:1. Simultaneous C-choline PET/MR could be safely used for detecting prostate cancer; SUVmax had a negative correlation with ADCmin in prostate disease; SUVmax/ADCmin may served as an effective diagnostic indicator for differentiating benign and malignant prostate lesions.2. The multi-parameter 11C-Choline PET/MRI have high sensitivity, specificity and accuracy in differentiate benign and malignant prostate lesions, it is very helpful to qualitative diagnosis of MRI suspicious prostate cancer. There is no relationship between the prostate cancer patients'PSA and SUVmax, ADCmin, SUVmax/ADCmin.