[11C]Choline uptake with PET/CT for the initial diagnosis of prostate cancer: relation to PSA levels, tumour stage and anti-androgenic therapy

  • Giampiero Giovacchini
  • Maria Picchio
  • Elisa Coradeschi
  • Vincenzo Scattoni
  • Valentino Bettinardi
  • Cesare Cozzarini
  • Massimo Freschi
  • Ferruccio Fazio
  • Cristina Messa
Original Article

DOI: 10.1007/s00259-008-0716-2

Cite this article as:
Giovacchini, G., Picchio, M., Coradeschi, E. et al. Eur J Nucl Med Mol Imaging (2008) 35: 1065. doi:10.1007/s00259-008-0716-2

Abstract

Purpose

The accuracy of positron emission tomography (PET)/CT with [11C]choline for the detection of prostate cancer is not well established. We assessed the dependence of [11C]choline maximum standardized uptake values (SUVmax) in the prostate gland on cell malignancy, prostate-specific antigen (PSA) levels, Gleason score, tumour stage and anti-androgenic hormonal therapy.

Methods

In this prospective study, PET/CT with [11C]choline was performed in 19 prostate cancer patients who subsequently underwent prostatectomy with histologic sextant analysis (group A) and in six prostate cancer patients before and after anti-androgenic hormonal therapy (bicalutamide 150 mg/day; median treatment of 4 months; group B).

Results

In group A, based on a sextant analysis with a [11C]choline SUVmax cutoff of 2.5 (as derived from a receiver-operating characteristic analysis), PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 72, 43, 64, 51 and 60%, respectively. In the patient-by-patient analysis, no significant correlation was detected between SUVmax and PSA levels, Gleason score or pathological stage. On the contrary, a significant (P < 0.05) negative correlation was detected between SUVmax and anti-androgenic therapy both in univariate (r2 = 0.24) and multivariate (r2 = 0.48) analyses. Prostate [11C]choline uptake after bicalutamide therapy significantly (P < 0.05) decreased compared to baseline (6.4 ± 4.6 and 11.8 ± 5.3, respectively; group B).

Conclusion

PET/CT with [11C]choline is not suitable for the initial diagnosis and local staging of prostate cancer. PET/CT with [11C]choline could be used to monitor the response to anti-androgenic therapy.

Keywords

[11C]Choline Prostate cancer PET/CT Anti-androgenic therapy 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Giampiero Giovacchini
    • 1
  • Maria Picchio
    • 2
  • Elisa Coradeschi
    • 1
  • Vincenzo Scattoni
    • 3
  • Valentino Bettinardi
    • 2
  • Cesare Cozzarini
    • 4
  • Massimo Freschi
    • 5
  • Ferruccio Fazio
    • 1
    • 2
    • 4
    • 6
  • Cristina Messa
    • 1
    • 6
    • 7
  1. 1.Center for Molecular BioimagingUniversity of Milano-BicoccaMilanItaly
  2. 2.Department of Nuclear MedicineScientific Institute San RaffaeleMilanItaly
  3. 3.Department of UrologyScientific Institute San RaffaeleMilanItaly
  4. 4.Department of Radiation OncologyScientific Institute San RaffaeleMilanItaly
  5. 5.Department of PathologyScientific Institute San RaffaeleMilanItaly
  6. 6.Institute for Bioimaging and Molecular PhysiologyNational Research CouncilMilanItaly
  7. 7.Department Nuclear Medicine, San Gerardo HospitalUniversity of Milano-BicoccaMonzaItaly

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