Sujets)
Humains , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Fumer/effets indésirables , Tomodensitométrie/effets indésirables , Tomographie par émission de positons/effets indésirables , Tumeurs du poumon/diagnostic , Tumeurs radio-induites/diagnostic , Dose de rayonnement , Tomodensitométrie/méthodes , Dépistage de masse/effets indésirables , Dépistage de masse/méthodes , Facteurs de risque , Appréciation des risques , Tomographie par émission de positons/méthodes , Dépistage précoce du cancer , Italie , Tumeurs du poumon/étiologie , Tumeurs du poumon/épidémiologie , Tumeurs radio-induites/étiologie , Tumeurs radio-induites/prévention et contrôle , Tumeurs radio-induites/épidémiologieRésumé
PURPOSE: To investigate the prevalence and clinical significance of incidental prostate fluoro-2-deoxyglucose (FDG) uptake and to evaluate its impact on patient management. MATERIALS AND METHODS: Of 47,109 men who underwent FDG positron emission tomography between 2004 and 2014, 1,335 (2.83%) demonstrated incidental FDG uptake in the prostate, with 99 of the latter undergoing prostate biopsy. The primary end point was the histological presence of prostate adenocarcinoma in the biopsy specimen. Outcomes, including treatment methods, survival, and causes of death, were also assessed. Factors associated with the diagnosis of prostate cancer were evaluated by using logistic regression analysis. RESULTS: Patients with prostate cancer were more likely to have higher serum prostate-specific antigen (PSA) (p=0.001) and focal FDG uptake (p=0.036) than were those without. Prostate cancer occurred in 1 of 26 patients (3.8%) with serum PSA or =2.5 ng/mL. Multivariable analysis showed that focal lesions (odds ratio [OR], 5.50; p=0.038), age (OR, 1.06; p=0.031), and serum PSA (OR, 1.28; p=0.001) were independent predictors of prostate cancer diagnosis. Most patients with prostate cancer had organ-confined tumors. Of these, 12 (29.3%) underwent radical prostatectomy and 25 (60.9%) received hormone therapy. Of the 11 patients who died, 9 died of primary cancer progression, with only 1 patient dying from prostate cancer. CONCLUSIONS: The prevalence of incidental FDG uptake in the prostate was not high, although patients with elevated serum PSA had a higher incidence of prostate cancer. Patients with FDG uptake in the prostate should be secondarily evaluated by measuring serum PSA, with those having high serum PSA undergoing prostate biopsy.