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Objectives: To study 18 F-Choline PET/CT in the diagnosis and biopsy guide of prostate cancer (pCa) in patients with persistently high prostate-specific antigen (PSA) and previous negative prostate biopsy. To compare the clinical risk factors and metabolic variables as predictors of malignancy., Methods: Patients with persistently elevated PSA in serum (total PSA >4ng/mL) and at least a previous negative or inconclusive biopsy were consecutively referred for a whole body 18 F-Choline PET/CT. Patient age, PSA level, PSA doubling time (PSAdt) and PSA velocity (PSAvel) were obtained. PET images were visually (positive or negative) and semiquantitatively (SUVmax) reviewed. 18 F-Choline uptake prostate patterns were defined as focal, multifocal, homogeneous or heterogeneous. Histology on biopsy using transrectal ultrasound-guided approach was the gold standard. Sensitivity (Se), specificity (Sp) and accuracy (Ac) of PET/CT for diagnosis of pCa were evaluated using per-patient and per-prostate lobe analysis. Receiver-operating-characteristic (ROC) curve analysis was used to assess the value of SUVmax to diagnose pCa. Correlation between PET/CT and biopsy results per-prostate lobe was assessed using the Chi-square test. Univariate and multivariate logistic regression analysis were applied to compare clinical risk factors and metabolic variables as predictors of malignancy., Results: Thirty-six out of 43 patients with histologic confirmation were included. In 11 (30.5%) patients, pCa was diagnosed (Gleason score from 4 to 9). The mean values of patient age, PSA level, PSAdt and PSAvel were: 65.5 years, 15.6ng/ml, 28.1 months and 8.5ng/mL per year, respectively. Thirty-three patients had a positive PET/CT; 18 had a focal pattern, 7 multifocal, 4 homogeneous and 4 heterogeneous. Se, Sp and Ac of PET/CT were of 100%, 12% and 38% in the patient based analysis, and 87%, 29% and 14% in the prostate lobe based analysis, respectively. The ROC curve analysis of SUVmax showed an AUC of 0.568 (p=0.52). On a lobe analysis, poor agreement was observed between PET/CT findings and biopsy results (p=0.097). In the univariate/multivariate analysis, none of clinical and metabolic variables were statistically significant as predictor of pCa., Conclusion: Choline PET/CT is a suitable procedure for the detection of pCa in highly selected patients, however, a high rate of false positive should be expected., (Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.)

Presentation of one case of CRE (crossed renale ectopia) with triplicity (trifidity) of the ortho and ectopic collector systems, due to the existence in both cases of pyelourethral bifidity and a third cranial blind ureter. This case represents a casual finding during a routine study of a female patient with orthostatic and exertion urinary incontinence (EUI). The case idiosyncrasies, which initially elicited the possibility of urethral ectopia, are analyzed. Incidence and variants of this unusual congenital anomaly are commented upon.

Retrospective review of r.h.c. (renal hydatid cysts) cases, since the opening of our hospital in March 1974 through December 1989. Four cases diagnosed with r.h.c., aged between 11 and 58 years, out of a total 15,700 patients seen in this centre throughout that time are presented. Emphasis is made on the rarity of this condition in spite of it being endemic in this area. The variety of its clinical forms together with the youth of two of the patients, have encouraged us to review, and make an in-depth reflection upon a subject about which there is an ever decreasing number of references to be found. We contribute the diagnostic value of the modern and highly demonstrative radiological image tests, echography and CAT.