Impact of sodium 18F-fluoride PET/CT, 18F-fluorocholine PET/CT and whole-body diffusion-weighted MRI on the management of patients with prostate cancer suspicious for metastasis: a prospective multicentre study

Mathieu Gauthé (1, 2) , Cyrielle Aveline (1) , Frédéric Lecouvet (3) , Laure Michaud (1) , Caroline Rousseau (4, 5) , Marc Tassart (1) , Olivier Cussenot (1, 6) , Jean-Noël Talbot (1) , Isabelle Durand-Zaleski (2, 7)

1 CHU Tenon [AP-HP]
2 ECEVE (U1123 / UMR_S_1123) - Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables
3 Centre du Cancer - Département de radiologie [Brussels, Belgium]
4 Unité de Médecine Nucléaire [ICO, Saint Herblain]
5 CRCINA-ÉQUIPE 13 - Nuclear Oncology
6 GRCTH - Groupe de Recherche Clinique et Technologique sur le Handicap
7 Service de santé publique [Mondor]

Purpose To compare the impact of 18F-sodium-fluoride (NaF) PET/CT, 18F-fluorocholine (FCH) PET/CT and diffusion-weighted whole-body MRI (DW-MRI) on the management of patients with prostate cancer (PCa) suspicious for distant metastasis. Methods Prostate cancer patients were prospectively included between December 2011 and August 2014 and benefited from these three whole-body imaging (WBI) modalities within 1 month in addition to the standard PCa workup. Management was prospectively decided by clinicians during two multidisciplinary meetings, before and after the whole-body imaging workup. Rates of induced changes of whole-body imaging modalities were compared by Cochran's Q test. Results One-hundred-one patients (27 at staging, 59 at first biochemical recurrence (BCR) and 15 at first episode of rising serum level of prostate-specific antigen during androgen-deprivation therapy) were included. The overall rate of management changes was 52%: 29% as a consequence of WBI, higher for FCH-PET/CT than for NaF-PET/CT or DW-MRI (p < 0.0001) and highest (41%) for FCH-PET/CT at BCR. Actual management was adequate in all patients but two. Conclusions Whole-body imaging induced a change in management in approximately a third of PCa patients suspicious for metastasis.

Mots clés: Impact on management; PET/CT; DW-MRI; Prostate cancer imaging; Progression-free survival

Domaines: Cancer

Mathieu Gauthé, Cyrielle Aveline, Frédéric Lecouvet, Laure Michaud, Caroline Rousseau, et al.. Impact of sodium 18F-fluoride PET/CT, 18F-fluorocholine PET/CT and whole-body diffusion-weighted MRI on the management of patients with prostate cancer suspicious for metastasis: a prospective multicentre study. World Journal of Urology, 2018, Epub ahead of print. ⟨10.1007/s00345-018-2547-5⟩. ⟨inserm-01981537⟩