Rechutes locales après curiethérapie de prostate : évaluation des performances diagnostiques de l’IRM et de la 18F-Choline-TEP/TDM et étude dosimétrique des sites de rechute

Abstract : Purpose: evaluation of MRI and FCH-PET/CT diagnostic performances for detection of local recurrence following prostate brachytherapy for localised prostate cancer. Methods: in this single-institution study we retrospectively reviewed data of all patients treated by brachytherapy for localized prostate cancer in our institution referred for biochemical recurrence according to Phoenix Criteria, who underwent MRI and FCH-PET/CT. We included patients without metastatic disease, with biopsy for the final assessment of local recurrence. Patient analysis data were supplemented by segment analysis using an 8-segment model. Results: the FCH-PET/CT was positive for 81% and negative for 19% of patients. The sensitivity and specificity were 92% and 33% with diagnosis accuracy of 67%. The MRI was positive for 57% and negative for 43% of patients. The sensitivity and specificity were 67% and 56% with diagnosis accuracy of 62%. There was no statistically significant difference between FCH-PET/CT and MRI accuracy (p=0.63). On a segment-based analysis, the sensitivity and specificity were 44% and 82% for FCH-PET/CT with diagnosis accuracy of 78%. For MRI specificity was 91% diagnosis accuracy 82%. Conclusion: both MRI and 18F-Choline-TEP/TDM permit to highlight local recurrence sites after prostate brachytherapy with the same accuracy. Confirmation biopsies are however necessary since this accuracy is insufficient.
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Master Thesis
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Vardouhie Karahissarlian-Robin. Rechutes locales après curiethérapie de prostate : évaluation des performances diagnostiques de l’IRM et de la 18F-Choline-TEP/TDM et étude dosimétrique des sites de rechute. Médecine humaine et pathologie. 2018. ⟨dumas-02077454⟩

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