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Published byVincent Stevens Modified over 9 years ago
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In biochemical recurrence after curative treatment of prostate cancer, Choline PET/CT 1- has a detection rate of 10-20% when PSA: 1-2 ng/ml 2- has a detection rate of 81% when PSA dt is less than 3 months 3- it best identifies patients with bone metastases 4- PET/CT is indicated for pre-op staging in case of suspicious MRI
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2-A negative Choline PET/CT is not sufficient to rule out the indication for lymph-adenectomy a-true b-false
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A 67 year old man has a T2b prostate cancer Gleason score 8, PSA: 8.7ng/ml. mpMRI shows extracapsular extension on the right, no enlarged lymph nodes 1- a bone scan is necessary 2- bone scan is more accurate for osteoclastic lesions 3- mp MRI of the prostate can detect all bone metastases 4- DW total body MRI is more sensitive than bone scan to R/O bone metastases
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The use of choline PET/CT for preoperative LN staging: 1- is indicated 2- high sensitivity but poor specificity 3- should be limited to patients with very high risk for LN positive status according to nomograms 4- has a low positive predicted value
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PET choline for detection of LN and distant recurrence in PC patients with biochemical recurrence 1- Significantly high detection rate with PSA <1 ng/ml 2- The Trigger PSA value is = or > 5g/ml 3- No relationship between detection rate and PSA kinetics 4- A crucial role as first diagnostic procedure in patients who demonstrate a fast growing PSA kinetics and low Trigger PSA
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choline PET/CT 1- could play a crucial role as first diagnostic procedure in PC patients 2- It is not recommended for initial diagnosis and staging as a first-line method 3- PSA dt could not be considered as an independent predictor of positive choline PET/CT 4- 18f choline PET/CT is not accurate to detect distant recurrence
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Dynamic Contrast Study 1.Based on density of tumor cells 2.Early enhancement of tumoral tissue in T2- weighted MRI 3.Delayed wash out of contrast agent are seen in prostate cancer 4.Early enhancement of tumoral tissue in T1 - weighted MRI
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Diffusion Weighted Imaging 1.Works based on angiogenesis 2.Water molecules movement increases in a high cellular environment 3.Sensitivity and specificity of DWI when added to T2-Weighted MRI for detecting prostate cancer is about 84% and 87% respectively 4.DW-MR imaging alone shows high sensitivity in cancer recurrence detection after radiotherapy
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MR Spectroscopy 1.Combination of choline and fluorocholine is measured in MRS 2.Citrate accumulates in the T zone 3.Citrate is higher in malignant prostatic tissue 4.A higher ratio of Cho+Cr/Ci (more than 0.75 ) is in favor of high risk of malignancy
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Regarding the use of Multiparametric MR imaging select the wrong answer Detection and local staging of prostate cancer Follow-up of patients after radical prostatectomy or radiation therapy Detection of skeletal metastasis Targeting biopsies in patients suspicious of prostate cancer
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