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

Authors

    • Department of Nuclear MedicineNational Cancer Institute–CRO Aviano (IRCCS)
  • Roberto Bortolus
    • Department of RadiotherapyNational Cancer Institute–CRO Aviano
  • Sandro Morassut
    • Department of RadiologyNational Cancer Institute–CRO Aviano
  • Vincenzo Canzonieri
    • Department of PathologyNational Cancer Institute–CRO Aviano
  • Antonio Garbeglio
    • Department of UrologyHospital S Maria degli Angeli
  • Tanja Baresic
    • Department of Nuclear MedicineNational Cancer Institute–CRO Aviano (IRCCS)
  • Eugenio Borsatti
    • Department of Nuclear MedicineNational Cancer Institute–CRO Aviano (IRCCS)
  • Annalisa Drigo
    • Medical Physics UnitNational Cancer Institute–CRO Aviano
  • Mauro G. Trovò
    • Department of RadiotherapyNational Cancer Institute–CRO Aviano
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

Choline PET Prostate cancer

Copyright information

© Springer-Verlag 2006