European Journal of Nuclear Medicine and Molecular Imaging

, Volume 33, Issue 12, pp 1387–1398

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

  • Marino Cimitan
  • Roberto Bortolus
  • Sandro Morassut
  • Vincenzo Canzonieri
  • Antonio Garbeglio
  • Tanja Baresic
  • Eugenio Borsatti
  • Annalisa Drigo
  • Mauro G. Trovò
Original article

DOI: 10.1007/s00259-006-0150-2

Cite this article as:
Cimitan, M., Bortolus, R., Morassut, S. et al. Eur J Nucl Med Mol Imaging (2006) 33: 1387. doi:10.1007/s00259-006-0150-2

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.

Keywords

CholinePETProstate cancer

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Marino Cimitan
    • 1
  • Roberto Bortolus
    • 2
  • Sandro Morassut
    • 3
  • Vincenzo Canzonieri
    • 4
  • Antonio Garbeglio
    • 5
  • Tanja Baresic
    • 1
  • Eugenio Borsatti
    • 1
  • Annalisa Drigo
    • 6
  • Mauro G. Trovò
    • 2
  1. 1.Department of Nuclear MedicineNational Cancer Institute–CRO Aviano (IRCCS)Aviano (PN)Italy
  2. 2.Department of RadiotherapyNational Cancer Institute–CRO AvianoAviano (PN)Italy
  3. 3.Department of RadiologyNational Cancer Institute–CRO AvianoAviano (PN)Italy
  4. 4.Department of PathologyNational Cancer Institute–CRO AvianoAviano (PN)Italy
  5. 5.Department of UrologyHospital S Maria degli AngeliPordenone (PN)Italy
  6. 6.Medical Physics UnitNational Cancer Institute–CRO AvianoAviano (PN)Italy