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Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer

European Journal of Nuclear Medicine and Molecular Imaging volume 35, pages 253–263 (2008)Cite this article

Abstract

Purpose

To evaluate the accuracy of [18F]-choline (FCH) positron emission tomography/computed tomography (PET/CT) for staging and restaging of prostate cancer.

Methods

FCH PET/CT was performed in 111 patients with prostate cancer using 200 MBq FCH: 43 patients [mean age 63 years; mean prostrate specific antigen (PSA) 11.58 μg/l] were examined for initial staging, and 68 patients (mean age 66.4 years) were examined for restaging (mean PSA 10.81 μg/l). FCH PET/CT results were correlated to histopathology, bone scan, morphology as revealed by magnetic resonance imaging (MRI) and CT, PET/CT follow-up and PSA follow-up after therapy.

Results

FCH PET/CT scans at initial staging correctly showed no metastases in 36/38 patients undergoing radical surgery, as confirmed by PSA levels <0.1 μg/l 6 months postoperatively. Lymphadenectomy was performed in 24 of these patients, revealing four false FCH-negative lymph nodes (LN). In one patient, only lymphadenectomy was performed since a FCH-positive LN was confirmed by histology. Four patients showed FCH-positive bone metastases, as proven by bone scan. FCH PET/CT scans at restaging correctly revealed local recurrence in 36 patients. No pathological FCH uptake was observed in 11 patients with biochemical recurrence. Twenty-three patients showed FCH-positive LN. Twenty LN were surgically removed in seven patients. Histopathology verified metastases in all LN, but revealed two additional metastastic, FCH-negative LN. Seventeen patients showed FCH-positive bone metastases, as proven by bone scan or MRI. Sensitivity to detect recurrent disease was 86%.

Conclusion

The results obtained using FCH PET/CT scans for initial N-staging were discouraging, especially in terms of its inability to detect small metastases. Recurrent disease can be localized reliably in patients with PSA levels of >2 μg/l.

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Affiliations

  1. Department of Nuclear Medicine, University Hospital of Zurich, C NUK 8a, Raemistrasse 100, 8091, Zürich, Switzerland

    Daniela B. Husarik, Tibor Cservenyàk & Thomas F. Hany

  2. Department of Radiation Oncology, University Hospital Geneva, Geneva, Switzerland

    Raymond Miralbell

  3. Department of Urology, Hospital of Uster, Uster, Switzerland

    Markus Dubs

  4. Department of Urology, Klinik Hirslanden, Zurich, Switzerland

    Hubert John

  5. Department of Pathology, University Hospital Zurich, Zurich, Switzerland

    Olivier T. Giger

  6. Department of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France

    Albert Gelet

Authors
  1. Daniela B. Husarik
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  2. Raymond Miralbell
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  3. Markus Dubs
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  4. Hubert John
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  5. Olivier T. Giger
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  6. Albert Gelet
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  7. Tibor Cservenyàk
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  8. Thomas F. Hany
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Correspondence to Daniela B. Husarik.

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Husarik, D.B., Miralbell, R., Dubs, M. et al. Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 35, 253–263 (2008). https://doi.org/10.1007/s00259-007-0552-9

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  • DOI: https://doi.org/10.1007/s00259-007-0552-9

Keywords

  • [18F]-Choline
  • Initial staging
  • PET-CT
  • Prostate cancer
  • Recurrence