Differentiation of prostate cancer and benign prostatic hyperplasia:: the clinical value of 201Tl SPECT -: a pilot study

Thallium-201 (Tl-201) is a recognized tumor-imaging agent; however, the usefulness of Tl-201 in prostate cancer has not been studied. The purpose of this preliminary study was to evaluate the efficacy of Tl-201 single-photon emission computed tomography (SPECT) imaging for differentiating prostate cancer from benign prostatic hyperplasia (BPH). Methods: Tl-201 pelvic SPECT was performed in 10 patients (aged 64-78 years) with biopsy-proven BPH before transurethral resection of the prostate and 15 patients (aged 65-81 years) with biopsy-proven prostate cancer prior to any therapeutic modality or invasive surgical procedures for treatment of their prostate cancer. Results: From the 15 patients with prostate cancer, Tl-201 pelvic SPECT detected prostate cancer in 13 (86.7%) but not in 2 (13.3%) patients with Gleason scores of 5 (2 + 3). In contrast, all 10 patients with BPH (100.0%) had negative results of Tl-201 pelvic SPECT. Conclusion: Our study showed that Tl-201 pelvic SPECT scan is very helpful in distinguishing between prostate cancer and BPH.