Original – Cáncer de próstata
Valor de la PET en la recurrencia del cáncer de próstata con PSA < 5 ng/ml
Usefulness of PET scans in diagnosing recurrent prostate cancer. Prostate with PSA level < 5ng/ml
Jorge Rioja Zuazua,
, Macarena Rodríguezb, Aníbal Rincón Mayansa, Abel Saiz Sansia, Juan Javier Zudaire Bergeraa, Rafael Martínez-Mongec, José Ángel Richterb, José María Berián Poloa
Autor para correspondencia
a Departamento de Urología, Clínica Universitaria, Universidad de Navarra, Pamplona, Navarra, España
b Departamento de Medicina Nuclear, Clínica Universitaria, Universidad de Navarra, Pamplona, Navarra, España
c Departamento de Oncología Radioterápica, Clínica Universitaria, Universidad de Navarra, Pamplona, Navarra, España
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Prostate with PSA level < 5<span class="elsevierStyleHsp" style=""></span>ng/ml" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-11-20" "fechaAceptado" => "2009-05-04" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec89424" "palabras" => array:8 [ 0 => "Tomografía por emisión" 1 => "de positrones" 2 => "Cáncer de próstata" 3 => "Recurrencia" 4 => "<span class="elsevierStyleSup">18</span>F-FDG" 5 => "<span class="elsevierStyleSup">11</span>C-colina" 6 => "Prostatectomía radical" 7 => "Radioterapia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec89423" "palabras" => array:7 [ 0 => "Positron emission tomography" 1 => "Prostate cancer" 2 => "Recurrence" 3 => "<span class="elsevierStyleSup">18</span>F-FDG" 4 => "<span class="elsevierStyleSup">11</span>C-choline" 5 => "Radical prostatectomy" 6 => "Radiation treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción y objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluamos la utilidad de la tomografía por emisión de positrones (PET) en el diagnóstico de la recurrencia del cáncer de próstata tras tratamiento con intención curativa.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se sometió a 92 pacientes consecutivos en progresión bioquímica tras cirugía radical (63) o radioterapia (29) a una PET. En todos los casos, se realizaron dos escáneres PET en el mismo día (<span class="elsevierStyleSup">11</span>C-colina y <span class="elsevierStyleSup">18</span>F-FDG). Se evalúa la eficacia de la PET de manera global (utilizando los resultados con <span class="elsevierStyleSup">11</span>C-colina y <span class="elsevierStyleSup">18</span>F-FDG) y de manera independiente para detectar recurrencia en pacientes con progresión bioquímica. Para ello, se utilizan la comparación de medias para k muestras independientes, tablas de contingencia 2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2 y 2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>X y curvas ROC.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">1</span>. PET global: hay evidencia de la alteración de la PET en función del antígeno prostático específico (PSA) (p = 0,003), estadio clínico (p = 0,01). No existe una alteración de la PET estadísticamente significativa en función de la afectación de la biopsia (unilateral o bilateral), los márgenes quirúrgicos, el estadio patológico y el tiempo a progresión. La curva ROC PET-PSA es significativa (p < 0,0001) y permite calcular distintos puntos de corte; PSA = 4,3<span class="elsevierStyleHsp" style=""></span>ng/ml el que presenta una mayor especificidad (91%). <span class="elsevierStyleItalic">2</span>. PET <span class="elsevierStyleSup">18</span>FDG: el área bajo la curva ROC es significativa (p < 0,0001), con una especificidad del 91% para un PSA = 6,51 ng/ml. <span class="elsevierStyleItalic">3</span>. PET <span class="elsevierStyleSup">11</span>colina: el área bajo la curva ROC es significativa (p < 0,0001), con una especificidad del 91% para un PSA = 5,15<span class="elsevierStyleHsp" style=""></span>ng/ml.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La PET es una herramienta útil en el diagnóstico de la recurrencia de cáncer de próstata tras tratamiento radical con intención curativa.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction and objectives</span><p class="elsevierStyleSimplePara elsevierViewall">We intend to evaluate the usefulness of PET scans in diagnosing recurrent prostate cancer after a curative attempt using radical treatment.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">92 consecutive prostate cancer patients in biochemical progression following radical surgery (63) or radiation treatment (29) were studied with positron emission tomography (PET). In all cases two scans were performed in the same day (<span class="elsevierStyleSup">11</span>C-choline and <span class="elsevierStyleSup">18</span>F-FDG). PET efficacy was evaluated both globally (by employing the results achieved with both <span class="elsevierStyleSup">11</span>C-choline and <span class="elsevierStyleSup">18</span>F-FDG) and using both radiotracers independently to detect recurrence in patients with biochemical progression. For this purpose, we used comparison of means for k-independent samples, 2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2 and 2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>X contingency tables and ROC curves.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">1</span>. Global PET: there is evidence of PET alteration regarding the PSA level (<span class="elsevierStyleItalic">P</span>=.003): the clinical stage (<span class="elsevierStyleItalic">P</span>=.01). There are no statistically significant PET alterations regarding the affected biopsy (uni or bilateral), surgical margins, pathological stage and time to progression. ROC curve PET-PSA is statistically significant (<span class="elsevierStyleItalic">P</span><.0001) permitting calculation of different cut-off points, with a specificity of 91% (highest) for a PSA of 4.3<span class="elsevierStyleHsp" style=""></span>ng/ml. <span class="elsevierStyleItalic">2</span>. PET <span class="elsevierStyleSup">18</span>FDG: the area under the ROC curve is statistically significant (<span class="elsevierStyleItalic">P</span><.0001) with a specificity of 91% for a PSA of 6.51<span class="elsevierStyleHsp" style=""></span>ng/ml. <span class="elsevierStyleItalic">3</span>. PET <span class="elsevierStyleSup">11</span>choline: the area under the ROC curve is statistically significant (<span class="elsevierStyleItalic">P</span><.0001) with a specificity of 91% for a PSA of 5.15<span class="elsevierStyleHsp" style=""></span>ng/ml.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">PET is a useful tool for diagnosing prostate cancer recurrence after a curative attempt using radical treatment.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:51 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Some limitations of the radioisotope bone scan in patients with metastatic prostatic cancer. A subanalysis of EORTC trial 30853. 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| 2013 Agosto | 15 | 3 | 18 |
| 2013 Julio | 9 | 0 | 9 |
| 2009 Agosto | 1545 | 0 | 1545 |
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