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3.
Transl Androl Urol ; 7(Suppl 4): S462-S476, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30363475

ABSTRACT

Prostate cancer is one of the most common cancers in men worldwide, and primary prostate cancer is typically treated with surgery, radiation, androgen deprivation, or a combination of these therapeutic modalities. Despite technical advances, approximately 30% of men will experience biochemical recurrent within 10 years of definitive treatment. Upon detection of a rise in serum prostate specific antigen (PSA), there is great need to accurately stage these patients to help guide further therapy. As a result, there are considerable efforts underway to establish the role of positron emission tomography (PET) in the diagnostic algorithm of biochemically recurrent prostate cancer. This manuscript provides an overview of PET tracers used for the detection and localization of prostate cancer in the setting of biochemical recurrence with a focus on PET tracers that are currently being used in clinical practice in the United States.

4.
Abdom Radiol (NY) ; 42(3): 727-734, 2017 03.
Article in English | MEDLINE | ID: mdl-27847998

ABSTRACT

PURPOSE: Determine iodine content threshold discriminating papillary renal cell carcinomas (pRCC) from complex cysts (CCs) using rapid kV-switching dual-energy CT (rsDECT). MATERIALS AND METHODS: IRB-approved retrospective study of 72 consecutive patients with pathologic diagnosis of renal cell carcinoma, who underwent rsDECT from 2011 to 2015. Controls included consecutive patients with CC during same period. Iodine content of each pRCC (n = 27) was measured on rsDECT workstation for arterial (n = 15) or nephrographic phase (n = 12), and compared to iodine content for clear cell renal cell carcinomas (ccRCC, n = 46) and complex cysts (n = 54). An optimal iodine content threshold was estimated using logistic regressions and Youden's J based on maximum specificity and sensitivity. RESULTS: Iodine threshold of 1.28 mg/cc was optimal to discriminate between pRCCs and CCs for nephrographic phase (sens 1.0, spec 0.96, PPV 0.92, and NPV 1.0, AUC 0.997, acc 0.97, p < 0.0001). Iodine threshold of 1.22 mg/cc was the optimal cutoff value to discriminate between pRCCs and CCs in the arterial phase (sens 0.67, spec 0.97, PPV 0.91, NPV 0.85, AUC 0.76, and acc 0.84, p = 0.006). The optimal threshold to discriminate between ccRCCs and pRCCs was 1.85 mg/cc in the arterial phase (sens 0.87, spec 0.92, PPV 0.87, NPV 0.92, p < 0001) and 2.71 mg/cc in the nephrographic phase (sens 1.0, spec 1.0, PPV 1.0, NPV 1.0, p < 0.0001). CONCLUSIONS: Quantitative iodine values on rsDECT discriminate between papillary RCC and complex cysts, and between papillary RCC and clear cell RCC, the former addressing an important clinical challenge particularly when an unenhanced series has not been performed. These rsDECT thresholds differ from values derived from dual-source DECT technology.


Subject(s)
Carcinoma, Papillary/diagnostic imaging , Carcinoma, Renal Cell/diagnostic imaging , Cysts/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Radiography, Abdominal/methods , Radiography, Dual-Energy Scanned Projection/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Carcinoma, Papillary/pathology , Carcinoma, Renal Cell/pathology , Contrast Media , Diagnosis, Differential , Female , Humans , Immunohistochemistry , Iohexol , Kidney Neoplasms/pathology , Male , Middle Aged , Neoplasm Grading , Sensitivity and Specificity
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