Diffusion-weighted MRI, (11)C-choline PET/CT, and (18)F-FDG PET/CT for predicting the Gleason score in prostate cancer.

OBJECTIVE: To evaluate diffusion-weighted magnetic resonance imaging (DWI), (11)C-choline positron emission tomography (PET), and fluorine-18-fluorodeoxyglucose ((18)F-FDG) PET for predicting Gleason score in prostate cancer patients. SUBJECTS AND METHODS: The study cohort included 11 patients with biopsy-proven prostate cancer who underwent DWI, (11)C-choline PET, and (18)F-FDG PET examinations before treatment. The correlations of Gleason score with those findings were determined using Spearman's test. Multi-technique imaging performance for separating higher Gleason score (>/=8) cases was also examined. RESULTS: Both diffusion coefficient (ADC) map and (11)C-choline PET/computed tomography (CT) findings showed prostate cancer in all 11 patients, while (18)F-FDG PET/CT was only successful in 6 (54.5%) cases, thus no further evaluations of that modality were performed. A moderately negative correlation was observed between Gleason score and ADC value for the primary tumor shown by DWI, though the difference was not significant (r=-0.49, P=0.13). In contrast, a strongly significant positive correlation was observed between Gleason score and maximum standardized uptake value (SUVmax) for the primary tumor in (11)C-choline PET findings (r=0.85, P=0.0010). Sensitivity, specificity, and accuracy for separating higher (>/=8) from lower (