[11C]choline PET/CT imaging in occult local relapse of prostate cancer after radical prostatectomy
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The aim of this study was to assess the accuracy and clinical impact of [11C]choline PET/CT for localizing occult relapse of prostate adenocarcinoma after radical prostatectomy.
Fourty-nine patients with prostate adenocarcinoma, radical prostatectomy, no evidence of metastatic disease, and occult relapse underwent [11C]choline PET/CT. Thirty-six of the patients had biochemical evidence and histological evaluation of local recurrence. Thirteen patients had PSA < 0.3 ng/ml and no evidence of active disease after 1 year follow-up. Focal nodular [11C]choline uptake in the prostatic fossa was visually assessed and graded on a five point scale. Maximum standardized radioactivity uptake value (SUVmax) and the lesion size were measured. A receiver operating characteristic (ROC) analysis was performed and the clinical impact of the PET/CT study was determined.
[11C]choline PET/CT was true positive in 23/33 patients and true negative in 12/13 controls. SUVmax of local recurrence was 3.0 (median, range 0.6–7.4) and 1.1 (0.4–1.6) in controls (p = 0.0002). Lesion size was 1.7 cm (range 0.9–3.7). Area under the ROC curve for detecting relapse was 0.90 ± 0.05 and 0.83 ± 0.06 for visual evaluation and SUVmax, respectively. Sensitivity and specificity of [11C]choline PET/CT were 0.73 and 0.88, respectively. [11C]choline PET/CT identified 12/17 (71%) patients with a favourable biochemical response to local radiotherapy at 2 year (median, 0.8–3.2 range) follow-up.
Focally increased [11C]choline uptake in the prostatic bed reliably predicted local low volume occult relapsing prostate adenocarcinoma after radical prostatectomy and identified 71% of patients with a favourable biochemical response to local radiotherapy.
KeywordsProstate cancer Local relapse PET/CT- [11C]choline
- 8.Cox JD, Gallagher MJ, Hammond EH, Kaplan RS, Schellhammer PF. Consensus statements on radiation therapy of prostate cancer: guidelines for prostate re-biopsy after radiation and for radiation therapy with rising prostate-specific antigen levels after radical prostatectomy. American Society for Therapeutic Radiology and Oncology Consensus Panel. J Clin Oncol 1999;17:1155–63.PubMedGoogle Scholar
- 25.Wittekind C, Meyer H, Bootz F. TNM- Klassifikation maligner Tumoren. 6th ed. Berlin Heidelberg New York: Springer; 2003.Google Scholar
- 35.Wachter S, Tomek S, Kurtaran A, Wachter-Gerstner N, Djavan B, Becherer A, et al. 11C-acetate positron emission tomography imaging and image fusion with computed tomography and magnetic resonance imaging in patients with recurrent prostate cancer. J Clin Oncol 2006;24:2513–9.PubMedCrossRefGoogle Scholar