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The Quarterly Journal of Nuclear Medicine 2001 September;45(3):235-44

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Local detection of prostate cancer by positron emission tomography with 2-fluorodeoxyglucose: comparison of filtered back projection and iterative reconstruction with segmented attenuation correction

Turlakow A. 1, Larson S. M. 1, Coakley F. 1, Akhurst T. 1, Gonen M. 2, Macapinlac H. A. 1, Kelly W. 3, Leibel S. 4, Humm J. 5, Scardino P. 6, Scher H. 3, Hricak H. 1

From the 1 Department of Radiology 2 Department of Biostatistics 3 Department of Medical Oncology 4 Department of Radiation Oncology 5 Department of Medical Physics 6 Department of Urology Memorial Sloab-Kettering Cancer Center, New York, USA


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Back­ground. To com­pare fil­tered ­back pro­jec­tion (FBP) and iter­a­tive recon­struc­tion ­with seg­mented atten­u­a­tion cor­rec­tion (­IRSAC) in the ­local ­imaging of pros­tate ­cancer by posi­tron emis­sion tomog­raphy ­with 2-flu­o­rod­e­ox­y­glu­cose (FDG-PET).
­Methods. We ret­ro­spec­tively iden­ti­fied 13 ­patients ­with pri­mary (n=7) or recur­rent (n=6) pros­tate ­cancer who had ­increased ­uptake in the pros­tate on FDG-PET per­formed ­without uri­nary cath­et­er­iza­tion, con­tem­po­ra­neous ­biopsy con­firming the pres­ence of ­active ­tumor in the pros­tate, and cor­rel­a­tive ­cross-sec­tional ­imaging by MRI (n=8) or CT (n=5). FDG-PET ­images ­were recon­structed by FBP and ­IRSAC. Two inde­pen­dent ­nuclear med­i­cine phy­si­cians sep­ar­ately ­rated FBP and ­IRSAC ­images for vis­u­al­iza­tion of pros­tatic ­activity on a ­4-­point ­scale. ­Results ­were com­pared ­using ­biopsy and ­cross-sec­tional ­imaging find­ings as the stan­dard of ref­er­ence.
­Results. ­IRSAC ­images ­were sig­nif­i­cantly ­better ­that FBP in ­terms of vis­u­al­iza­tion of pros­tatic ­activity in 12 of 13 ­patients, and ­were equiv­a­lent in 1 ­patient (p<0.001, Wil­coxon ­signed ­ranks ­test). In par­tic­ular, 2 ­foci of ­tumor ­activity in 2 dif­ferent ­patients ­seen on ­IRSAC ­images ­were not vis­ible on FBP ­images. In 11 ­patients who had a ­gross ­tumor ­mass evi­dent on ­cross-sec­tional ­imaging, ­there was ­good agree­ment ­between PET and ­cross-sec­tional ana­tomic ­imaging ­with ­respect to ­tumor local­iza­tion.
Con­clu­sions. In ­selected ­patients, ­cancer can be ­imaged ­within the pros­tate ­using FDG-PET, and ­IRSAC is ­superior to FBP in ­image recon­struc­tion for ­local ­tumor vis­u­al­iza­tion.

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