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Master Thesis

FLUPROSTIC : place de la TEP/TDM au Fluor-18 et de l’IRM de diffusion « corps entier » dans la détection des premières métastases osseuses du cancer de la prostate

Abstract : Purpose: the occurrence of bone metastases is an important prognostic factor and a turning point in the therapeutic management of prostate cancer. Three innovative imaging studies have become increasingly important in their search: NaF PET-CT, FCH PET-CT and whole-body MRI with diffusion-weighted sequences. The main objective of this study is to compare their diagnostic performances in detecting the occurrence of bone metastatic dissemination. Method: 111 men with prostate cancer were enrolled in this prospective multi-center national study and 85 were included in the analysis. Within less than a month, they received all 3 exams. The diagnostic performances were determined from blind readings after comparison with the standard of truth established according to the monitoring data collected during a mean follow-up of 22 months. Results : 11 patients were metastatic to bone (12.9%). Regardless of the patient's initial risk level, the performances of FCH PET-CT, NaF PET-CT and whole-body MRI are equivalent at the bone level (Se 75%, 92%, 67%, p = 0.368, and Sp 99%, 95%, 96%, p = 0.05). However, on a patient-based analysis, FCH PET-CT showed better sensitivity than MRI (Se 89% vs 27%, p < 0.0001), detecting more sites affected by extra-osseous disease. This results in a greater clinical impact rate of PET-CT on therapeutic management than that of MRI. Conclusion : this study showed equivalent performances in detecting bone metastases between the 3 techniques, but higher patient-based performances of FCH PET-CT. It appears thus appropriate to grant a prominent place for FCH PET-CT, allowing, within the framework of an overall assessment of the disease extent, a reliable search of a bone metastatic extension without misunderstanding an extra-osseous extension.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01703396
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Cyrielle Aveline. FLUPROSTIC : place de la TEP/TDM au Fluor-18 et de l’IRM de diffusion « corps entier » dans la détection des premières métastases osseuses du cancer de la prostate. Médecine humaine et pathologie. 2017. ⟨dumas-01703396⟩

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