Prospective Comparison of F-18 Choline PET/CT Scan Versus Axial MRI for Detecting Bone Metastasis in Biochemically Relapsed Prostate Cancer Patients

• Main Authors: Wouter Huysse, Frédéric Lecouvet, Paolo Castellucci, Piet Ost, Valerie Lambrecht, Carlos Artigas, Marie-Laurence Denis, Kathia De Man, Louke Delrue, Lennart Jans, Aurélie De Bruycker, Filip De Vos, Gert De Meerleer, Karel Decaestecker, Valerie Fonteyne, Bieke Lambert
• Format: Article
• Language: English
• Published: MDPI AG 2017-10-01
• Series: Diagnostics
• Subjects: choline PET/CT; MRI; bone metastasis; prostate cancer
• Online Access: https://www.mdpi.com/2075-4418/7/4/56
• ISSN: 2075-4418

We compared fluor-18 choline positron emission tomography/computed tomography (PET/CT) and axial skeleton magnetic resonance imaging (MRI) prospectively obtained for the detection of bone metastases in non-castrated patients with biochemically recurrent prostate cancer following primary treatment. PET/CT was performed 45 min post-injection of 3–4 MBq/kg F-18 methyl choline. MRI included T1- and fluid sensitive T2-weighted images of the spine and pelvis. Readers were initially blinded from other results and all scans underwent independent double reading. The best valuable comparator (BVC) defined the metastatic status. On the basis of the BVC, 15 out of 64 patients presented with 24 bone metastases. On a patient level, the sensitivity and specificity of MRI and PET were not significantly different. On a lesion level, the sensitivity of MRI was significantly better compared to PET, and the specificity did not differ significantly. In conclusion, axial MRI is an interesting screening tool for the detection of bone metastases because of its low probability of false negative results. However, F-18 choline PET is a valuable addition as it can overrule false positive MRI results and detect non-axial metastases.