Comparison of C-11-Choline With F-18-FDG in Positron Emission Tomography/Computerized Tomography for Staging Urothelial Carcinoma: A Prospective Study

作者：Golan Shay^*; Sopov Vladimir; Baniel Jack; Groshar David

来源：Journal of Urology, 2011, 186(2): 436-441.

DOI：10.1016/j.juro.2011.03.121

• carcinoma, transitional cell
• positron-emission tomography
• tomography, emission-computed
• choline
• fluorodeoxyglucose F18

Purpose: C-11-choline was postulated to provide better diagnostic capabilities than other tracers used in positron emission tomography/computerized tomography for staging urothelial carcinoma. We compared the value of using C-11-choline with the well investigated F-18-FDG tracer in this setting.
Materials and Methods: The study group included 20 consecutive patients with bladder cancer who underwent evaluation for local and metastatic disease using C-11-choline and F-18-FDG positron emission tomography/computerized tomography. Patients were treated with radical cystectomy with lymph node dissection, radiation therapy or chemotherapy independent of positron emission tomography/computerized tomography results. The histopathological findings (when available), followup positron emission tomography and radiological imaging served as the reference standard. Using the paired t test we compared the maximum standardized uptake and lesion-to-background ratio of the tracers. The positive predictive values were determined.
Results: A total of 51 lesions showed abnormal tracer activity. The positive predictive value for all detected lesions was 84.7% for C-11-choline positron emission tomography/computerized tomography and 90.7% for F-18-FDG positron emission tomography/computerized tomography. The corresponding positive predictive values for extravesical lesions were 79.4% and 88.2%, respectively. Discrepant findings between the tracers were noted at 11 sites. F-18-FDG positron emission tomography/computerized tomography correctly identified 4 extravesical metastases missed by choline positron emission tomography/computerized tomography in the absence of a contrary observation. Mean maximum standardized uptake and lesion-to-background ratio at extravesical sites were significantly higher for FDG.
Conclusions: Within the limitations of a relatively small number of patients and partial histopathological analysis, C-11-choline positron emission tomography/computerized tomography appears to have no advantage compared to F-18-FDG positron emission tomography/computerized tomography in the detection of metastatic bladder cancer. F-18-FDG positron emission tomography/computerized tomography has a tendency toward greater accuracy.

• 出版日期2011-8