Relationship between prostatic fluorodeoxyglucose uptake, prostatic calcifications, and urologic symptom questionnaires

OBJECTIVES: This study evaluated the potential clinical value of fluorodeoxyglucose (FDG) PET/computed tomography (CT) for assessing urological symptom questionnaires including National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Prostate Symptom Score (IPSS), and quality of life (QoL) measures. Relationships among incidental prostate FDG uptake, prostatic calcifications (PCs), urological symptom questionnaires in men undergoing health screening were explored. METHODS: Men who underwent health checkups including FDG PET/CT and completed urological symptom questionnaires were enrolled. Multiple clinical parameters such as prostate-specific antigen were used as adjustment variables. Univariate analyses compared groups based on the presence/absence of FDG uptake and calcification. Multiple logistic regression and Spearman correlation evaluated associations with symptom scores. RESULTS: Of 368 participants, 104 presented FDG uptake or calcification, where 31 exhibited positive FDG uptake, 84 had PCs, and 11 patients presented both. Spearman's correlation revealed strong associations between IPSS scores or QoL and total CPSI (r = 0.60 and 0.58, P < 0.001 for both). In univariate analysis, participants with FDG uptake, prostatic calcification, or at least one of the two findings had significantly higher NIH-CPSI, IPSS, and QoL scores than their respective counterparts without each finding (all P < 0.01). In multivariate logistic regression, prostatic FDG uptake and calcification were associated with higher IPSS and QoL scores (P < 0.001, for both). CONCLUSION: Prostate FDG uptake and calcification observed on FDG PET/CT were strongly associated with higher urological symptom questionnaires. FDG PET/CT may provide adjunctive information about latent urinary tract symptoms and supplement the evaluation of chronic prostatitis/chronic pelvic pain syndrome.