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Is the detection rate of 18F-choline PET/CT influenced by androgen-deprivation therapy?

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Abstract

Purpose

To evaluate if the detection rate (DR) of 18F-choline (18F-CH) PET/CT is influenced by androgen-deprivation therapy (ADT) in patients with prostate cancer (PC) already treated with radical intent and presenting biochemical relapse.

Materials and methods

We have retrospectively evaluated 18F-CH PET/CT scans of 325 consecutive PC patients enrolled in the period November 2009 to December 2012 previously treated with radical intent and referred to our centre to perform 18F-CH PET/CT for biochemical relapse. Two different groups of patients were evaluated. group A included the whole sample of 325 patients (mean age 70 years, range: 49–86) who presented trigger PSA between 0.1 and 80 ng/ml (mean 5.5 ng/ml), and group B included 187 patients (mean age 70 years, range 49–86) with medium-low levels of trigger PSA ranging between 0.5 and 5 ng/ml (mean PSA 2.1 ng/ml); group B was chosen in order to obtain a more homogeneous group of patients in terms of PSA values also excluding both very low and very high PSA levels avoiding the “a priori” higher probability of negative or positive PET scan, respectively. At the time of examination, 139 patients from group A and 72 patients from group B were under ADT: these patients were considered to be hormone-resistant PC patients because from their oncologic history (>18 months) an increase of PSA levels emerged despite the ongoing ADT. The relationship between 18F-CH PET/CT findings and possible clinical predictors was investigated using both univariate and multivariate binary logistic regression analyses, including trigger PSA and ADT.

Results

Considering the whole population, overall DR of 18F-CH PET was 58.2 % (189/325 patients). In the whole sample of patients (group A), both at the univariate and multivariate logistic regression analysis, trigger PSA and ADT were significantly correlated with the DR of 18F-CH PET (p < 0.05). Moreover, the DR in patients under ADT (mean PSA 7.8 ng/ml) was higher than in patients not under ADT (mean PSA 3.9 ng/ml), (DR was 70.5 % and 48.9 %, respectively; p < 0.001), therefore, demonstrating the existence of a significant correlation between the DR of 18F-CH PET and ADT. In group B patients only trigger PSA resulted a reliable predictor of the 18F-CH positivity, since ADT was not correlated to the DR of 18F-CH PET (p = 0.061). Also in group B the DR of 18F-CH PET in patients under ADT was higher than in patients not under ADT (65.3 % and 51.3 %, respectively) but the difference was not significant without a statistically significant correlation in the Mann Whitney test (p = 0.456) therefore, suggesting the lack of correlation between DR 18F-CH PET/CT and ADT.

Conclusion

Similarly to previous published studies, in our series the overall DR of 18F-CH PET/CT was 58 % and was significantly correlated to trigger PSA. The most important finding of the present study is that ADT does not negatively influence DR of 18F-CH PET/CT in PC patients with biochemical relapse; therefore, it can be suggested that it is not necessary to withdraw ADT before performing 18F-CH PET/CT.

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The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, PET/CT Centre, “Santa Maria della Misericordia” Hospital, Via Tre Martiri 140, 45100, Rovigo, Italy

    Sotirios Chondrogiannis, Maria Cristina Marzola, Gaia Grassetto, Anna Margherita Maffione, Lucia Rampin & Domenico Rubello

  2. Service of Medical Physics, “San Giacomo Apostolo” Hospital, Castelfranco Veneto, Treviso, Italy

    Alice Ferretti

  3. Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy

    Stefano Fanti

  4. Department of Nuclear Medicine, Centre Hospitalier Lyon Sud Biophysique, Faculté Charles Mérieux Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France

    Francesco Giammarile

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  1. Sotirios Chondrogiannis
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  2. Maria Cristina Marzola
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  3. Alice Ferretti
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  4. Gaia Grassetto
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  5. Anna Margherita Maffione
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  6. Lucia Rampin
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  9. Domenico Rubello
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Correspondence to Sotirios Chondrogiannis.

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Chondrogiannis, S., Marzola, M.C., Ferretti, A. et al. Is the detection rate of 18F-choline PET/CT influenced by androgen-deprivation therapy?. Eur J Nucl Med Mol Imaging 41, 1293–1300 (2014). https://doi.org/10.1007/s00259-014-2720-z

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  • DOI: https://doi.org/10.1007/s00259-014-2720-z

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