World Journal of Urology

, Volume 31, Issue 2, pp 319–323

Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer

  • Maxim Rybalov
  • Anthonius J. Breeuwsma
  • Anna M. Leliveld
  • Jan Pruim
  • Rudi A. Dierckx
  • Igle J. de Jong
Original Article

DOI: 10.1007/s00345-012-0908-z

Cite this article as:
Rybalov, M., Breeuwsma, A.J., Leliveld, A.M. et al. World J Urol (2013) 31: 319. doi:10.1007/s00345-012-0908-z

Abstract

Purpose

To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of 11C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT).

Methods

We included 185 patients with BCR after RP (PSA >0.2 ng/ml) or after EBRT (ASTRO definition). After injection of 400 MBq 11C-Choline i.v., a scan was made using the ECAT HR + PET camera with CT fusion images or Siemens mCT PET/CT. Biopsy-proven histology, confirmative imaging (CT or bone scan) and/or clinical follow-up (PSA) were used as composite reference. Statistical analysis was performed using PASW Statistics 18.

Results

11C-Choline PET was positive in 124/185 cases (65 %) (in 22/61 (36 %) after RP, 102/124 (82 %) after EBRT). In 79 patients a local recurrence was identified, and 45 patients showed locoregional metastases on PET/CT. In 20 cases a proven false-negative PET scan was observed. Positive PET scans were confirmed by histology in 87/124 (70 %) cases, by confirmatory imaging in 34/124 (28 %) and by clinical follow-up after salvage treatment in 3 (2 %) cases. The ROC analysis to detect a recurrence showed significant difference in area under the curve (AUC) of tPSA 0.721(p < 0.001) and PSA velocity 0.730 (p < 0.001). PSA doubling time showed no significant difference with an AUC of 0.542 (p = 0.354). Detection rates are <50 % in tPSA <2 ng/ml and/or PSA velocity <1 ng/ml/year.

Conclusions

Total serum PSA and PSA velocity have significant effect on the detection rates of 11C-Choline PET/CT in men with a BCR after RP or EBRT.

Keywords

11C-Choline PETProstate cancerRecurrencePSAKinetics

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Maxim Rybalov
    • 1
  • Anthonius J. Breeuwsma
    • 1
  • Anna M. Leliveld
    • 1
  • Jan Pruim
    • 2
  • Rudi A. Dierckx
    • 2
  • Igle J. de Jong
    • 1
  1. 1.Department of UrologyUniversity Medical Center GroningenGroningenThe Netherlands
  2. 2.Department of Nuclear Medicine and Molecular ImagingUniversity Medical Center GroningenGroningenThe Netherlands