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[18F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients

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Abstract

Purpose

We evaluated the potential of PET/CT and [18F]fluoromethylcholine (FCH) in the assessment of suspected recurrence of prostate cancer after treatment.

Methods

One hundred consecutive prostate cancer patients with a persistent increase in serum PSA (>0.1 ng/ml) after radical prostatectomy (58 cases), radiotherapy (21 cases) or hormonal therapy alone (21 cases) were investigated. After injection of 3.7–4.07 MBq/kg of FCH, both early (at <15 min) and delayed (at >60 min) PET/CT scans were performed in 43 patients, delayed PET/CT scans in 53 patients and early PET/CT scans in four patients.

Results

Of the 100 patients, 54 (PSA 0.22–511.79 ng/ml) showed positive FCH PET/CT scans. Thirty-seven patients had bone and/or abdominal lymph node uptake, while 17 showed pelvic activity. Malignant disease was confirmed in all but one. Delayed SUVmax of bone metastases was significantly higher (p<0.0001 by paired t test) than that measured at <15 min, whereas no differences were observed between early and delayed SUVs of malignant lymph nodes or pelvic disease. Forty-six patients (PSA 0.12–14.3 ng/ml) showed negative FCH PET/CT scans. Of the negative PET/CT scans, 89% were obtained in patients with serum PSA <4 ng/ml and 87% in patients with a Gleason score <8. In none of these cases could recurrent tumour be proven clinically during a follow-up of 6 months.

Conclusion

FCH PET/CT is not likely to have a significant impact on the care of prostate cancer patients with biochemical recurrence until PSA increases to above 4 ng/ml. However, in selected patients, FCH PET/CT helps to exclude distant metastases when salvage local treatment is intended.

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Acknowledgements

We would like to thank Cassa di Risparmio di Udine e Pordenone and Acropolis Foundations for their generous donation of the CT equipment of the PET/CT scanner.

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Authors and Affiliations

  1. Department of Nuclear Medicine, National Cancer Institute–CRO Aviano (IRCCS), Via Pedemontana Occidentale 12, 33081, Aviano (PN), Italy

    Marino Cimitan, Tanja Baresic & Eugenio Borsatti

  2. Department of Radiotherapy, National Cancer Institute–CRO Aviano, Aviano (PN), Italy

    Roberto Bortolus & Mauro G. Trovò

  3. Department of Radiology, National Cancer Institute–CRO Aviano, Aviano (PN), Italy

    Sandro Morassut

  4. Department of Pathology, National Cancer Institute–CRO Aviano, Aviano (PN), Italy

    Vincenzo Canzonieri

  5. Department of Urology, Hospital S Maria degli Angeli, Pordenone (PN), Italy

    Antonio Garbeglio

  6. Medical Physics Unit, National Cancer Institute–CRO Aviano, Aviano (PN), Italy

    Annalisa Drigo

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  1. Marino Cimitan
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Correspondence to Marino Cimitan.

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Cimitan, M., Bortolus, R., Morassut, S. et al. [18F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging 33, 1387–1398 (2006). https://doi.org/10.1007/s00259-006-0150-2

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  • DOI: https://doi.org/10.1007/s00259-006-0150-2

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