Clinical significance of incidental prostatic fluorine-18-fluorodeoxyglucose uptake in the diagnosis of infectious prostatitis in adult males


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Abstract

BackgroundWe performed a work-up study of cancer patients with incidentally found uncharacterized prostatic fluorine-18-fluorodeoxyglucose (18F-FDG) uptake in 18F-FDG PET/CT results. Then, we evaluated the clinical significance of the incidental prostate 18F-FDG uptake (IPU) in nonmalignant prostate tissues.Patients and methodsOverall, 51 men agreed to a physical prostate examination and an expressed prostatic secretion (EPS) test within 2 weeks after torso 18F-FDG PET/CT scans. We then reviewed the 18F-FDG PET/CT scans of the enrolled patients and evaluated the relationship between the 18F-FDG PET/CT, prostate-specific antigen, and prostatic laboratory findings.ResultsThe pathological diagnosis of five men indicated the presence of prostate cancer, and of the remaining 46 men, 27 cases showed IPU in the 18F-FDG PET/CT whereas 19 did not. The characteristics of the enrolled patients were as follows: mean age of 61.15±13.79 years (range: 30–83 years), maximum standardized uptake value of 2.64±1.33 (range: 1.2–7.1), and prostate-specific antigen of 3.10±3.50 ng/ml (range: 0.16–13.55 ng/ml). Ten of the 27 (37%) patients with IPU in the PET/CT scan showed bacterial infections in their prostate. A multivariate analysis indicated that the bacterial presence in the EPS increased the risk of IPU (adjusted odds ratio: 9.167; P=0.019).ConclusionBacterial presence in the prostate tends to increase the likelihood of IPU in 18F-FDG PET/CT scans. Therefore, men with incidental prostate 18F-FDG uptake should be considered for a possible prostate infection in addition to a concomitant malignancy.

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