%0 Journal Article
%T What Is the Clinical Significance of FDG Unexpected Uptake in the Prostate in Patients Undergoing PET/CT for Other Malignancies?
%A Priya Bhosale
%A Aparna Balachandran
%A Raghu Vikram
%A Chitra Viswanathan
%A Homer Macapinlac
%A Eric Rohren
%A Ramanujan Prativadi
%J International Journal of Molecular Imaging
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/476786
%X Purpose. To determine the clinical significance of unexpected, abnormal FDG uptake in the prostate in patients undergoing FDG-PET/CT for staging of other primary malignancies without a prior history of prostate carcinoma. Methods. Retrospective search of FDG-PET/CT studies to identify patients with unexpected, abnormal FDG uptake in the prostate gland, who underwent subsequent biopsy, was performed. 26 patients were identified. Images were reviewed to determine the pattern of uptake within the prostate (focal or diffuse) and maximum standardized uptake value (SUVmax). PSA and Gleason scores were recorded. Results. 15/26 (58%) patients were found to have prostate carcinoma. Gleason scores ranged from 6 to 9.9. There was no statistical difference in the pattern of uptake (focal versus diffuse) or the SUVmax. Serum PSA levels with cancer (range, 2¨C26.8£¿ng; mean, 10.2£¿ng) and those without cancer (range, 2¨C10.5£¿ng; mean, 2.2£¿ng) were statistically significant ( , Wilcoxon rank sum test). Conclusions. Patients with abnormal uptake in the prostate have a 58% likelihood of occult prostate cancer. In the setting of elevated serum PSA levels, abnormal prostate uptake should therefore be viewed with suspicion and a urology consult should be obtained; however, it is irrelevant in patients with underlying aggressive malignancies. 1. Introduction Prostate cancer causes more deaths than any other cancer in men aged 55 to 74 years in many industrialized countries [1], and it is diagnosed incidentally in up to 28% of patients. The median age at diagnosis of prostate cancer is 67 years [2]. Prostate cancer is often regarded as an indolent malignancy and a disease that evolves over many years with aging; the premise for detecting and treating prostate cancer is a subject of debate. Currently serial elevation of serum prostate-specific antigen (PSA) levels and an abnormal digital rectal exam raise the suspicion for prostate cancer. Fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET/CT) is an imaging modality that is, increasingly, being used for assessing cancer stage, response to therapy, and surveillance after treatment in various malignancies. Incidental uptake of FDG is occasionally noted within the prostate [3]; whether this finding is associated with prostate cancer or not is not adequately established. The purpose of this study was to determine the association between ¡°incidentally¡± noted FDG uptake in the prostate gland and occult prostate carcinoma. 2. Patients and Methods Institutional review board approval was obtained for this retrospective study.
%U http://www.hindawi.com/journals/ijmi/2013/476786/