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Does lymph node localization affect prostate-specific membrane antigen uptake?

Sönmezer, Buraka; Acar, Emineb,c; Erkoyun, Erdemd; Capa Kaya, Gamzee

doi: 10.1097/MNM.0000000000001032
Original article: PDF Only

Objective To investigate the relationship between lymph node (LN) size and localization and prostate-specific membrane antigen (PSMA) uptake in patients with prostate cancer.

Patients and methods Between February 2015 and February 2017, a total of 178 patients diagnosed with prostate adenocarcinoma by gallium-68 PSMA PET/computed tomography were evaluated. Seventy-eight patients with LN PSMA uptake were included in the study.

The short-axis diameter and maximum and mean standardized uptake values (SUV) were measured from axial images of LNs with PSMA uptake. LN conglomerates were considered a single lesion. Patients were divided into two groups according to the presence (group 1) or absence (group 2) of bone uptake in addition to the LN uptake; subgroups were constituted according to the short-axis diameter and PSMA-positive LN region for each group. LNs were classified according to their localization as pelvic, abdominal, or cervical/thoracic.

Results In both groups, the SUV were significantly higher in LNs with short-axis diameters more than 8 mm than those with diameters up to 8 mm (P<0.001 and <0.001, respectively). Also, both groups showed a moderate correlation between the LN size and SUV.

When the analysis was carried out according to the localization, but after excluding the LN conglomerates, the correlation between the pelvic and abdominal LNs was higher in the second group.

Conclusion The highest significant positive correlation between LN size and SUV was in patients with pelvic and abdominal LN metastases without bone involvement according to the gallium-68 PSMA PET/computed tomography images in our study.

aDepartment of Nuclear Medicine, Manisa City Hospital, Şehzadeler/Manisa

bDepartment of Nuclear Medicine, Atatürk Training and Research Hospital, İzmir Katip Çelebi University

cDepartment of Translational Oncology, Graduate School of Health Sciences, Dokuz Eylül University

dİzmir Provincial Health Directorate, Public Health Services

eDepartment of Nuclear Medicine, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey

Correspondence to Burak Sönmezer, MD, Department of Nuclear Medicine, Manisa City Hospital, Manisa 45040, Turkey Tel: +90 236 229 2600; fax: +90 236 229 2659; e-mail:

Received December 20, 2018

Received in revised form March 3, 2019

Accepted April 22, 2019

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