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

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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.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Urology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands

    Maxim Rybalov, Anthonius J. Breeuwsma, Anna M. Leliveld & Igle J. de Jong

  2. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Jan Pruim & Rudi A. Dierckx

Authors
  1. Maxim Rybalov
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  2. Anthonius J. Breeuwsma
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  3. Anna M. Leliveld
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  4. Jan Pruim
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  5. Rudi A. Dierckx
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  6. Igle J. de Jong
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Correspondence to Maxim Rybalov.

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Rybalov, M., Breeuwsma, A.J., Leliveld, A.M. et al. Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer. World J Urol 31, 319–323 (2013). https://doi.org/10.1007/s00345-012-0908-z

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  • DOI: https://doi.org/10.1007/s00345-012-0908-z

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