[18 F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients
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We evaluated the potential of PET/CT and [18F]fluoromethylcholine (FCH) in the assessment of suspected recurrence of prostate cancer after treatment.
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.
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.
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.
- [18F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients
European Journal of Nuclear Medicine and Molecular Imaging
Volume 33, Issue 12 , pp 1387-1398
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- Prostate cancer
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- Author Affiliations
- 1. Department of Nuclear Medicine, National Cancer Institute–CRO Aviano (IRCCS), Via Pedemontana Occidentale 12, 33081, Aviano (PN), Italy
- 2. Department of Radiotherapy, National Cancer Institute–CRO Aviano, Aviano (PN), Italy
- 3. Department of Radiology, National Cancer Institute–CRO Aviano, Aviano (PN), Italy
- 4. Department of Pathology, National Cancer Institute–CRO Aviano, Aviano (PN), Italy
- 5. Department of Urology, Hospital S Maria degli Angeli, Pordenone (PN), Italy
- 6. Medical Physics Unit, National Cancer Institute–CRO Aviano, Aviano (PN), Italy