PET/CT with 11C-choline for evaluation of prostate cancer patients with biochemical recurrence: meta-analysis and critical review of available data

  • Stefano Fanti
  • Silvia Minozzi
  • Paolo Castellucci
  • Sara Balduzzi
  • Ken Herrmann
  • Bernd Joachim Krause
  • Wim Oyen
  • Arturo Chiti
Original Article



For the last decade PET and PET/CT with 11C-choline have been proposed for the evaluation of prostate cancer (PC), but the diagnostic performance of 11C-choline PET/CT is still a matter of debate. We performed a comprehensive review of the most important clinical application of 11C-choline PET, restaging of patients with biochemical relapse, following a rigorous methodological approach and including assessment of the risk of bias. We conducted a systematic review and meta-analysis of the literature assessing 11C-choline PET/CT for its accuracy in the diagnosis and ability to detect the site of recurrence of PC in the restaging of patients with biochemical recurrence after initial treatment with curative intent.


We performed a comprehensive literature search of PubMed and the Cochrane Library to determine the accuracy for the detection of the site of recurrence (prostate bed recurrences, metastatic spread to locoregional pelvic lymph nodes or distant metastases). Only studies with a reference standard (for prostatic bed histopathology, for histopathology or biopsy of distant metastases or a composite reference standard with clinical follow-up of at least 12 months, correlative imaging and clinical data) were included.


Overall 425 studies were retrieved, of which 43 were judged as potentially relevant and 29 with 2,686 participants were finally included. Of these 29 studies, 18 reported results for any relapse, All 18 studies, with a total of 2,126 participants, reported detection rates. The pooled rate was 62 % (95 % CI 53 – 71 %). Of the 18 studies, 12 with 1,270 participants reported useful data to derive sensitivity and specificity. The pooled sensitivity was 89 % (95 % CI 83 – 93 %) and the pooled specificity was 89 % (95 % CI 73 – 96 %). Of 11 studies reporting results for local relapse, 9 with 993 participants reported detection rates. The pooled rate was 27 % (95 % CI 16 – 38 %). Six studies with 491 participants reported sensitivity and specificity. The pooled sensitivity was 61 % (95 % CI 40 – 80 %) and the pooled specificity was 97 % (95 % CI 87 – 99 %). Ten studies reported results for lymph nodes and distant metastases. For nodal disease, 7 studies with 752 participants reported detection rates. The pooled rate was 36 % (95 % CI 22 – 50 %). For bone metastases, 8 studies with 775 participants reported detection rates. The pooled rate was 25 % (95 % CI 16 – 34 %).


There is a significant amount of 11C-choline PET data published showing a high degree of consistency in inclusion criteria, acquisition protocols and scan interpretation criteria. Furthermore, the quality of the data derived limited to the same standard of reference was acceptable. Despite a high variability in the observed prevalence of any relapse, the diagnostic performance of 11C-choline PET was in line with previous meta-analyses. Our data confirm the very good accuracy of 11C-choline PET for detection of lymph node metastases and/or distant lesions in a single examination in patients with biochemical relapse.


Prostate cancer Positron emission tomography 11C-Choline 


Compliance with ethical standards


This study was partly funded by the EANM (honorarium to Silvia Minozzi) as part of a project to promote the approval of new tracers for clinical use.

Conflicts of Interest


Ethical approval

This article does not describe any studies with human participants or animals performed by any of the authors.


  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29. doi: 10.3322/caac.21254.CrossRefPubMedGoogle Scholar
  2. 2.
    Picchio M, Mapelli P, Panebianco V, Castellucci P, Incerti E, Briganti A, et al. Imaging biomarkers in prostate cancer: role of PET/CT and MRI. Eur J Nucl Med Mol Imaging. 2015;42:644–55. doi: 10.1007/s00259-014-2982-5.CrossRefPubMedGoogle Scholar
  3. 3.
    Evangelista L, Zattoni F, Guttilla A, Saladini G, Zattoni F, Colletti PM, et al. Choline PET or PET/CT and biochemical relapse of prostate cancer: a systematic review and meta-analysis. Clin Nucl Med. 2013;38:305–14. doi: 10.1097/RLU.0b013e3182867f3c.CrossRefPubMedGoogle Scholar
  4. 4.
    Umbehr MH, Muntener M, Hany T, Sulser T, Bachmann LM. The role of 11C-choline and 18F-fluorocholine positron emission tomography (PET) and PET/CT in prostate cancer: a systematic review and meta-analysis. Eur Urol. 2013;64:106–17. doi: 10.1016/j.eururo.2013.04.019.CrossRefPubMedGoogle Scholar
  5. 5.
    Brogsitter C, Zophel K, Kotzerke J. 18F-Choline, 11C-choline and 11C-acetate PET/CT: comparative analysis for imaging prostate cancer patients. Eur J Nucl Med Mol Imaging. 2013;40 Suppl 1:S18–27. doi: 10.1007/s00259-013-2358-2.CrossRefPubMedGoogle Scholar
  6. 6.
    Yu CY, Desai B, Ji L, Groshen S, Jadvar H. Comparative performance of PET tracers in biochemical recurrence of prostate cancer: a critical analysis of literature. Am J Nucl Med Mol Imaging. 2014;4:580–601.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Mohler JL, Armstrong AJ. NCCN clinical practice guidelines in oncology. Prostate cancer, version 1.2015. National Comprehensive Cancer Network; 2015.Google Scholar
  8. 8.
    Mottet N, Bellmunt J, Briers E, van den Bergh RCN, Bolla M, van Casteren NJ, et al. Guidelines on Prostate Cancer. Eur Soc Urol. 2015.Google Scholar
  9. 9.
    Picchio M, Briganti A, Fanti S, Heidenreich A, Krause BJ, Messa C, et al. The role of choline positron emission tomography/computed tomography in the management of patients with prostate-specific antigen progression after radical treatment of prostate cancer. Eur Urol. 2011;59:51–60. doi: 10.1016/j.eururo.2010.09.004.CrossRefPubMedGoogle Scholar
  10. 10.
    Macaskill P, Gatsonis C, Deeks JJ, Harbord RM, Takwoingi Y. Chapter 10: Analysing and presenting results. In: Deeks JJ, Bossuyt PM, Gatsonis C (editors). Cochrane handbook for systematic reviews of diagnostic test accuracy version 1.0. The Cochrane Collaboration, 2010.Google Scholar
  11. 11.
    Roach 3rd M, Hanks G, Thames Jr H, Schellhammer P, Shipley WU, Sokol GH, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65:965–74. doi: 10.1016/j.ijrobp.2006.04.029.CrossRefPubMedGoogle Scholar
  12. 12.
    Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–36. doi: 10.7326/0003-4819-155-8-201110180-00009.CrossRefPubMedGoogle Scholar
  13. 13.
    DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.CrossRefPubMedGoogle Scholar
  14. 14.
    Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration; 2011.Google Scholar
  15. 15.
    Reitsma JB, Glas AS, Rutjes AW, Scholten RJ, Bossuyt PM, Zwinderman AH. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol. 2005;58:982–90. doi: 10.1016/j.jclinepi.2005.02.022.CrossRefPubMedGoogle Scholar
  16. 16.
    Eschmann SM, Pfannenberg AC, Rieger A, Aschoff P, Muller M, Paulsen F, et al. Comparison of 11C-choline-PET/CT and whole body-MRI for staging of prostate cancer. Nuklearmedizin. 2007;46:161–8, quiz N47-8.PubMedGoogle Scholar
  17. 17.
    Kotzerke J, Prang J, Neumaier B, Volkmer B, Guhlmann A, Kleinschmidt K, et al. Experience with carbon-11 choline positron emission tomography in prostate carcinoma. Eur J Nucl Med. 2000;27:1415–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Luboldt W, Kufer R, Blumstein N, Toussaint TL, Kluge A, Seemann MD, et al. Prostate carcinoma: diffusion-weighted imaging as potential alternative to conventional MR and 11C-choline PET/CT for detection of bone metastases. Radiology. 2008;249:1017–25. doi: 10.1148/radiol.2492080038.CrossRefPubMedGoogle Scholar
  19. 19.
    Tuncel M, Souvatzoglou M, Herrmann K, Stollfuss J, Schuster T, Weirich G, et al. [(11)C]Choline positron emission tomography/computed tomography for staging and restaging of patients with advanced prostate cancer. Nucl Med Biol. 2008;35:689–95. doi: 10.1016/j.nucmedbio.2008.05.006.CrossRefPubMedGoogle Scholar
  20. 20.
    Osmonov DK, Heimann D, Janssen I, Aksenov A, Kalz A, Juenemann KP. Sensitivity and specificity of PET/CT regarding the detection of lymph node metastases in prostate cancer recurrence. Springerplus. 2014;3:340. doi: 10.1186/2193-1801-3-340.PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Beheshti M, Langsteger W. Choline PET/CT compared with bone scintigraphy in the detection of bone metastases in prostate cancer patients. Eur J Nucl Med Mol Imaging. 2012;39:910–1, author reply 912–913. doi: 10.1007/s00259-011-2046-z.CrossRefPubMedGoogle Scholar
  22. 22.
    Garcia JR, Cuberas G, Riera E, Soler M, Moragas M, Lomena F. Dual-phase 11C-choline PET/computed tomography in the early evaluation of prostate cancer recurrence. Nucl Med Commun. 2015;36:8–15. doi: 10.1097/MNM.0000000000000207.CrossRefPubMedGoogle Scholar
  23. 23.
    Giovacchini G, Picchio M, Parra RG, Briganti A, Gianolli L, Montorsi F, et al. Prostate-specific antigen velocity versus prostate-specific antigen doubling time for prediction of 11C choline PET/CT in prostate cancer patients with biochemical failure after radical prostatectomy. Clin Nucl Med. 2012;37:325–31. doi: 10.1097/RLU.0b013e31823363b0.CrossRefPubMedGoogle Scholar
  24. 24.
    Goldstein J, Even-Sapir E, Ben-Haim S, Saad A, Spieler B, Davidson T, et al. Does choline PET/CT change the management of prostate cancer patients with biochemical failure? Am J Clin Oncol. 2014. doi: 10.1097/COC.0000000000000139.PubMedGoogle Scholar
  25. 25.
    Alongi F, Comito T, Villa E, Lopci E, Cristina I, Mancosu P, et al. What is the role of [11C]choline PET/CT in decision making strategy before post-operative salvage radiation therapy in prostate cancer patients? Acta Oncol. 2014;53:990–2. doi: 10.3109/0284186X.2013.865078.CrossRefPubMedGoogle Scholar
  26. 26.
    Giovacchini G, Picchio M, Garcia-Parra R, Briganti A, Abdollah F, Gianolli L, et al. 11C-choline PET/CT predicts prostate cancer-specific survival in patients with biochemical failure during androgen-deprivation therapy. J Nucl Med. 2014;55:233–41. doi: 10.2967/jnumed.113.123380.CrossRefPubMedGoogle Scholar
  27. 27.
    Jereczek-Fossa BA, Rodari M, Bonora M, Fanti P, Fodor C, Pepe G, et al. [11C]choline PET/CT impacts treatment decision making in patients with prostate cancer referred for radiotherapy. Clin Genitourin Cancer. 2014;12:155–9. doi: 10.1016/j.clgc.2013.11.002.CrossRefPubMedGoogle Scholar
  28. 28.
    Nanni C, Schiavina R, Brunocilla E, Borghesi M, Ambrosini V, Zanoni L, et al. 18F-FACBC compared with 11C-choline PET/CT in patients with biochemical relapse after radical prostatectomy: a prospective study in 28 patients. Clin Genitourin Cancer. 2014;12:106–10. doi: 10.1016/j.clgc.2013.08.002.CrossRefPubMedGoogle Scholar
  29. 29.
    Picchio M, Berardi G, Fodor A, Busnardo E, Crivellaro C, Giovacchini G, et al. (11)C-Choline PET/CT as a guide to radiation treatment planning of lymph-node relapses in prostate cancer patients. Eur J Nucl Med Mol Imaging. 2014;41:1270–9. doi: 10.1007/s00259-014-2734-6.CrossRefPubMedGoogle Scholar
  30. 30.
    Bertagna F, Abuhilal M, Bosio G, Simeone C, Rossini P, Pizzocaro C, et al. Role of (11)C-choline positron emission tomography/computed tomography in evaluating patients affected by prostate cancer with suspected relapse due to prostate-specific antigen elevation. Jpn J Radiol. 2011;29:394–404. doi: 10.1007/s11604-011-0570-1.CrossRefPubMedGoogle Scholar
  31. 31.
    Breeuwsma AJ, Pruim J, van den Bergh AC, Leliveld AM, Nijman RJ, Dierckx RA, et al. Detection of local, regional, and distant recurrence in patients with PSA relapse after external-beam radiotherapy using (11)C-choline positron emission tomography. Int J Radiat Oncol Biol Phys. 2010;77:160–4. doi: 10.1016/j.ijrobp.2009.04.090.CrossRefPubMedGoogle Scholar
  32. 32.
    Castellucci P, Fuccio C, Nanni C, Santi I, Rizzello A, Lodi F, et al. Influence of trigger PSA and PSA kinetics on 11C-choline PET/CT detection rate in patients with biochemical relapse after radical prostatectomy. J Nucl Med. 2009;50:1394–400. doi: 10.2967/jnumed.108.061507.CrossRefPubMedGoogle Scholar
  33. 33.
    Castellucci P, Fuccio C, Rubello D, Schiavina R, Santi I, Nanni C, et al. Is there a role for (11)C-choline PET/CT in the early detection of metastatic disease in surgically treated prostate cancer patients with a mild PSA increase <1.5 ng/ml? Eur J Nucl Med Mol Imaging. 2011;38:55–63. doi: 10.1007/s00259-010-1604-0.CrossRefPubMedGoogle Scholar
  34. 34.
    Ceci F, Castellucci P, Graziani T, Schiavina R, Brunocilla E, Mazzarotto R, et al. 11C-choline PET/CT detects the site of relapse in the majority of prostate cancer patients showing biochemical recurrence after EBRT. Eur J Nucl Med Mol Imaging. 2014;41:878–86. doi: 10.1007/s00259-013-2655-9.CrossRefPubMedGoogle Scholar
  35. 35.
    Ceci F, Castellucci P, Mamede M, Schiavina R, Rubello D, Fuccio C, et al. (11)C-Choline PET/CT in patients with hormone-resistant prostate cancer showing biochemical relapse after radical prostatectomy. Eur J Nucl Med Mol Imaging. 2013;40:149–55. doi: 10.1007/s00259-012-2272-z.CrossRefPubMedGoogle Scholar
  36. 36.
    Ceci F, Herrmann K, Castellucci P, Graziani T, Bluemel C, Schiavina R, et al. Impact of 11C-choline PET/CT on clinical decision making in recurrent prostate cancer: results from a retrospective two-centre trial. Eur J Nucl Med Mol Imaging. 2014;41:2222–31. doi: 10.1007/s00259-014-2872-x.CrossRefPubMedGoogle Scholar
  37. 37.
    de Jong IJ, Pruim J, Elsinga PH, Vaalburg W, Mensink HJ. 11C-choline positron emission tomography for the evaluation after treatment of localized prostate cancer. Eur Urol. 2003;44:32–8, discussion 38–9.Google Scholar
  38. 38.
    Fuccio C, Castellucci P, Schiavina R, Guidalotti PL, Gavaruzzi G, Montini GC, et al. Role of 11C-choline PET/CT in the re-staging of prostate cancer patients with biochemical relapse and negative results at bone scintigraphy. Eur J Radiol. 2012;81:e893–6. doi: 10.1016/j.ejrad.2012.04.027.CrossRefPubMedGoogle Scholar
  39. 39.
    Fuccio C, Castellucci P, Schiavina R, Santi I, Allegri V, Pettinato V, et al. Role of 11C-choline PET/CT in the restaging of prostate cancer patients showing a single lesion on bone scintigraphy. Ann Nucl Med. 2010;24:485–92. doi: 10.1007/s12149-010-0390-x.CrossRefPubMedGoogle Scholar
  40. 40.
    Giovacchini G, Picchio M, Coradeschi E, Bettinardi V, Gianolli L, Scattoni V, et al. Predictive factors of [(11)C]choline PET/CT in patients with biochemical failure after radical prostatectomy. Eur J Nucl Med Mol Imaging. 2010;37:301–9. doi: 10.1007/s00259-009-1253-3.CrossRefPubMedGoogle Scholar
  41. 41.
    Giovacchini G, Picchio M, Scattoni V, Garcia Parra R, Briganti A, Gianolli L, et al. PSA doubling time for prediction of [(11)C]choline PET/CT findings in prostate cancer patients with biochemical failure after radical prostatectomy. Eur J Nucl Med Mol Imaging. 2010;37:1106–16. doi: 10.1007/s00259-010-1403-7.CrossRefPubMedGoogle Scholar
  42. 42.
    Kitajima K, Murphy RC, Nathan MA, Froemming AT, Hagen CE, Takahashi N, et al. Detection of recurrent prostate cancer after radical prostatectomy: comparison of 11C-choline PET/CT with pelvic multiparametric MR imaging with endorectal coil. J Nucl Med. 2014;55:223–32. doi: 10.2967/jnumed.113.123018.CrossRefPubMedGoogle Scholar
  43. 43.
    Krause BJ, Souvatzoglou M, Tuncel M, Herrmann K, Buck AK, Praus C, et al. The detection rate of [11C]choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer. Eur J Nucl Med Mol Imaging. 2008;35:18–23. doi: 10.1007/s00259-007-0581-4.CrossRefPubMedGoogle Scholar
  44. 44.
    Mamede M, Ceci F, Castellucci P, Schiavina R, Fuccio C, Nanni C, et al. The role of 11C-choline PET imaging in the early detection of recurrence in surgically treated prostate cancer patients with very low PSA level <0.5 ng/mL. Clin Nucl Med. 2013;38:e342–5. doi: 10.1097/RLU.0b013e31829af913.CrossRefPubMedGoogle Scholar
  45. 45.
    Mitchell CR, Lowe VJ, Rangel LJ, Hung JC, Kwon ED, Karnes RJ. Operational characteristics of (11)C-choline positron emission tomography/computerized tomography for prostate cancer with biochemical recurrence after initial treatment. J Urol. 2013;189:1308–13. doi: 10.1016/j.juro.2012.10.069.CrossRefPubMedGoogle Scholar
  46. 46.
    Passoni NM, Suardi N, Abdollah F, Picchio M, Giovacchini G, Messa C, et al. Utility of [11C]choline PET/CT in guiding lesion-targeted salvage therapies in patients with prostate cancer recurrence localized to a single lymph node at imaging: results from a pathologically validated series. Urol Oncol. 2014;32:38 e9–16.Google Scholar
  47. 47.
    Picchio M, Messa C, Landoni C, Gianolli L, Sironi S, Brioschi M, et al. Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]fluorodeoxyglucose-positron emission tomography. J Urol. 2003;169:1337–40. doi: 10.1097/01.ju.0000056901.95996.43.CrossRefPubMedGoogle Scholar
  48. 48.
    Picchio M, Spinapolice EG, Fallanca F, Crivellaro C, Giovacchini G, Gianolli L, et al. [11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: comparison with bone scintigraphy. Eur J Nucl Med Mol Imaging. 2012;39:13–26. doi: 10.1007/s00259-011-1920-z.CrossRefPubMedGoogle Scholar
  49. 49.
    Reske SN, Blumstein NM, Glatting G. [11C]choline PET/CT imaging in occult local relapse of prostate cancer after radical prostatectomy. Eur J Nucl Med Mol Imaging. 2008;35:9–17. doi: 10.1007/s00259-007-0530-2.CrossRefPubMedGoogle Scholar
  50. 50.
    Richter JA, Rodriguez M, Rioja J, Penuelas I, Marti-Climent J, Garrastachu P, et al. Dual tracer 11C-choline and FDG-PET in the diagnosis of biochemical prostate cancer relapse after radical treatment. Mol Imaging Biol. 2010;12:210–7. doi: 10.1007/s11307-009-0243-y.CrossRefPubMedGoogle Scholar
  51. 51.
    Rinnab L, Mottaghy FM, Blumstein NM, Reske SN, Hautmann RE, Hohl K, et al. Evaluation of [11C]-choline positron-emission/computed tomography in patients with increasing prostate-specific antigen levels after primary treatment for prostate cancer. BJU Int. 2007;100:786–93. doi: 10.1111/j.1464-410X.2007.07083.x.CrossRefPubMedGoogle Scholar
  52. 52.
    Rinnab L, Mottaghy FM, Simon J, Volkmer BG, de Petriconi R, Hautmann RE, et al. [11C]Choline PET/CT for targeted salvage lymph node dissection in patients with biochemical recurrence after primary curative therapy for prostate cancer. Preliminary results of a prospective study. Urol Int. 2008;81:191–7. doi: 10.1159/000144059.CrossRefPubMedGoogle Scholar
  53. 53.
    Rybalov M, Breeuwsma AJ, Leliveld AM, Pruim J, Dierckx RA, de Jong IJ. 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. 2013;31:319–23. doi: 10.1007/s00345-012-0908-z.CrossRefPubMedGoogle Scholar
  54. 54.
    Rybalov M, Breeuwsma AJ, Pruim J, Leliveld AM, Rosati S, Veltman NC, et al. [11C]choline PET for the intraprostatic tumor characterization and localization in recurrent prostate cancer after EBRT. Q J Nucl Med Mol Imaging. 2012;56:202–8.PubMedGoogle Scholar
  55. 55.
    Scattoni V, Picchio M, Suardi N, Messa C, Freschi M, Roscigno M, et al. Detection of lymph-node metastases with integrated [11C]choline PET/CT in patients with PSA failure after radical retropubic prostatectomy: results confirmed by open pelvic-retroperitoneal lymphadenectomy. Eur Urol. 2007;52:423–9. doi: 10.1016/j.eururo.2007.03.032.CrossRefPubMedGoogle Scholar
  56. 56.
    Schilling D, Schlemmer HP, Wagner PH, Bottcher P, Merseburger AS, Aschoff P, et al. Histological verification of 11C-choline-positron emission/computed tomography-positive lymph nodes in patients with biochemical failure after treatment for localized prostate cancer. BJU Int. 2008;102:446–51. doi: 10.1111/j.1464-410X.2008.07592.x.CrossRefPubMedGoogle Scholar
  57. 57.
    Yoshida S, Nakagomi K, Goto S, Futatsubashi M, Torizuka T. 11C-choline positron emission tomography in prostate cancer: primary staging and recurrent site staging. Urol Int. 2005;74:214–20. doi: 10.1159/000083551.CrossRefPubMedGoogle Scholar
  58. 58.
    Rinnab L, Simon J, Hautmann RE, Cronauer MV, Hohl K, Buck AK, et al. [(11)C]choline PET/CT in prostate cancer patients with biochemical recurrence after radical prostatectomy. World J Urol. 2009;27:619–25. doi: 10.1007/s00345-009-0371-7.CrossRefPubMedGoogle Scholar
  59. 59.
    Salminen E, Hogg A, Binns D, Frydenberg M, Hicks R. Investigations with FDG-PET scanning in prostate cancer show limited value for clinical practice. Acta Oncol. 2002;41:425–9.CrossRefPubMedGoogle Scholar
  60. 60.
    Decaestecker K, De Meerleer G, Ameye F, Fonteyne V, Lambert B, Joniau S, et al. Surveillance or metastasis-directed Therapy for OligoMetastatic Prostate cancer recurrence (STOMP): study protocol for a randomized phase II trial. BMC Cancer. 2014;14:671. doi: 10.1186/1471-2407-14-671.PubMedCentralCrossRefPubMedGoogle Scholar
  61. 61.
    Rutjes AW, Reitsma JB, Coomarasamy A, Khan KS, Bossuyt PM. Evaluation of diagnostic tests when there is no gold standard. A review of methods. Health Technol Assess. 2007;11:iii, ix–51.Google Scholar
  62. 62.
    Gurusamy KS, Davidson BR. Diagnostic accuracy of different imaging modalities following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer. Cochrane Database Syst Rev. 2015:CD011515. doi: 10.1002/14651858.CD011515.
  63. 63.
    Crawford F, McIntosh H, Dozier M, Brush J, Glanville JM, Dunlop MG, et al. FDG PET-CT imaging for pre operative staging in patients with colorectal cancer. Cochrane Database Syst Rev. 2012:CD009630. doi: 10.1002/14651858.CD009630.
  64. 64.
    Castellucci P, Fanti S. Prostate cancer: identifying sites of recurrence with choline-PET-CT imaging. Nat Rev Urol. 2015;12:134–5. doi: 10.1038/nrurol.2014.321.CrossRefPubMedGoogle Scholar
  65. 65.
    Shen G, Deng H, Hu S, Jia Z. Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis. Skelet Radiol. 2014;43:1503–13. doi: 10.1007/s00256-014-1903-9.CrossRefGoogle Scholar
  66. 66.
    Mease RC, Foss CA, Pomper MG. PET imaging in prostate cancer: focus on prostate-specific membrane antigen. Curr Top Med Chem. 2013;13:951–62.PubMedCentralCrossRefPubMedGoogle Scholar
  67. 67.
    Treglia G, Ceriani L, Sadeghi R, Giovacchini G, Giovanella L. Relationship between prostate-specific antigen kinetics and detection rate of radiolabelled choline PET/CT in restaging prostate cancer patients: a meta-analysis. Clin Chem Lab Med. 2014;52(5):725–33. doi: 10.1515/cclm-2013-0675.

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Stefano Fanti
    • 1
  • Silvia Minozzi
    • 2
  • Paolo Castellucci
    • 1
  • Sara Balduzzi
    • 3
  • Ken Herrmann
    • 4
    • 5
  • Bernd Joachim Krause
    • 6
  • Wim Oyen
    • 7
  • Arturo Chiti
    • 8
    • 9
  1. 1.Department of Nuclear MedicineS.Orsola-Malpighi University HospitalBolognaItaly
  2. 2.Cochrane Review Group on Drugs and Alcohol, Department of EpidemiologyLazio Regional Health ServiceRomeItaly
  3. 3.Department of Diagnostic Medicine, Clinical and Public HealthUniversity of Modena and Reggio EmiliaModenaItaly
  4. 4.Department of Molecular and Medical PharmacologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  5. 5.Department of Nuclear MedicineUniversity Hospital WürzburgWürzburgGermany
  6. 6.Department of Nuclear MedicineUniversitätsmedizin RostockRostockGermany
  7. 7.Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
  8. 8.Nuclear MedicineHumanitas Research HospitalRozzanoItaly
  9. 9.Humanitas UniversityRozzanoItaly

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