PET/CT Imaging in Prostate Cancer: Indications and Perspectives for Radiation Therapy

Part of the Medical Radiology book series (MEDRAD)


The goal of prostate cancer therapy is to administer risk-adjusted and patient-specific treatment with maximal cancer control and minimal side effects. Modern radiation techniques such as IMRT and IGRT for example enable application of high dose irradiation to the primary/dominant intraprostatic cancer lesions, to a local recurrent nodule after radical prostatectomy, or to the loco-regional lymph node metastases. Such approaches promise to offer significantly improved long term results but require most accurate imaging tools with the ability to reliably detect not only the primary tumor and nodal involvement but more importantly to precisely indicate their location and extent. In addition presence of distant disease should be reliably detected or excluded. In this review we present a detailed overview over numerous PET/CT-studies, with emphasis on choline-PET/CT, that investigated performance of PET/CT in different clinical scenarios, spanning from the initial presentation to PSA recurrent disease. We discuss benefits and limitations of this imaging device in the primary and salvage setting from the radio-oncologists point of view. In the situation of PSA recurrence, there is increasing evidence that in addition to local salvage RT of the prostate fossa after radical prostatectomy, salvage lymph node therapy seems feasible and advantageous for a significant proportion of patients. The accuracy of choline-PET/CT depends on absolute PSA level, PSA kinetics and the investigation depth level (e.g. lesion based vs. region based vs. patient based). Incorporation of metabolic information from Choline PET/CT or other forthcoming PET-tracers with similar or higher accuracy in the process of RT treatment volume definition appears beneficial for both primary and loco-regional recurrence, when lymph node therapy is indicated.


Radical Prostatectomy Biochemical Relapse Gross Target Volume Salvage Lymph Node Dissection Dominant Intraprostatic Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Afshar-Oromieh A et al (2014) Comparison of PET imaging with a (68)Ga-labelled PSMA ligand and (18)F-choline-based PET/CT for the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging 41(1):11–20Google Scholar
  2. Albrecht S et al (2007) (11)C-acetate PET in the early evaluation of prostate cancer recurrence. Eur J Nucl Med Mol Imaging 34(2):185–196PubMedGoogle Scholar
  3. Bading JR, Shields AF (2008) Imaging of cell proliferation: status and prospects. J Nucl Med 49(2):64S–80SPubMedGoogle Scholar
  4. Bauman G et al (2012) 18F-fluorocholine for prostate cancer imaging: a systematic review of the literature. Prostate Cancer Prostatic Dis 15(1):45–55PubMedGoogle Scholar
  5. Beheshti M et al (2008) Detection of bone metastases in patients with prostate cancer by 18F fluorocholine and 18F fluoride PET-CT: a comparative study. Eur J Nucl Med Mol Imaging 35(10):1766–1774PubMedGoogle Scholar
  6. Beheshti M et al (2009) The use of F-18 choline PET in the assessment of bone metastases in prostate cancer: correlation with morphological changes on CT. Mol Imaging Biol 11(6):446–454PubMedGoogle Scholar
  7. Beheshti M et al (2010) 18F choline PET/CT in the preoperative staging of prostate cancer in patients with intermediate or high risk of extracapsular disease: a prospective study of 130 patients. Radiology 254(3):925–933PubMedGoogle Scholar
  8. Bernard JR Jr et al (2010) Salvage radiotherapy for rising prostate-specific antigen levels after radical prostatectomy for prostate cancer: dose-response analysis. Int J Radiat Oncol Biol Phys 76(3):735–740PubMedGoogle Scholar
  9. Beyer T et al (2004) Acquisition protocol considerations for combined PET/CT imaging. J Nucl Med 45(1):25S–35SPubMedGoogle Scholar
  10. Boellaard R (2009) Standards for PET image acquisition and quantitative data analysis. J Nucl Med 50(1):11S–20SPubMedGoogle Scholar
  11. Boellaard R et al (2004) Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study. J Nucl Med 45(9):1519–1527PubMedGoogle Scholar
  12. Boellaard R et al (2010) FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging 37(1):181–200PubMedCentralPubMedGoogle Scholar
  13. Bott SR et al (2010) The index lesion and focal therapy: an analysis of the pathological characteristics of prostate cancer. BJU Int 106(11):1607–1611PubMedGoogle Scholar
  14. Bouchelouche K, Capala J (2010) Image and treat1: an individualized approach to urological tumors. Curr Opin Oncol 22(3):274–280PubMedCentralPubMedGoogle Scholar
  15. Bouchelouche K et al (2010) Imaging prostate cancer: an update on positron emission tomography and magnetic resonance imaging. Curr Urol Rep 11(3):180–190PubMedCentralPubMedGoogle Scholar
  16. Briganti A et al (2009) Two positive nodes represent a significant cut-off value for cancer specific survival in patients with node positive prostate cancer. A new proposal based on a two-institution experience on 703 consecutive N + patients treated with radical prostatectomy, extended pelvic lymph node dissection and adjuvant therapy. Eur Urol 55(2):261–270PubMedGoogle Scholar
  17. Casamassima F et al (2011) Efficacy of eradicative radiotherapy for limited nodal metastases detected with choline PET scan in prostate cancer patients. Tumori 97(1):49–55PubMedGoogle Scholar
  18. Casciani E et al (2008) Endorectal and dynamic contrast-enhanced MRI for detection of local recurrence after radical prostatectomy. AJR Am J Roentgenol 190(5):1187–1192PubMedGoogle Scholar
  19. Castellucci P, Jadvar H (2012) PET/CT in prostate cancer: non-choline radiopharmaceuticals. Q J Nucl Med Mol Imaging 56(4):367–374PubMedCentralPubMedGoogle Scholar
  20. Castellucci P et al (2009) 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 50(9):1394–1400PubMedGoogle Scholar
  21. Castellucci P et al (2011) Is there a role for (1)(1)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 38(1):55–63PubMedGoogle Scholar
  22. Cellini N et al (2002) Analysis of intraprostatic failures in patients treated with hormonal therapy and radiotherapy: implications for conformal therapy planning. Int J Radiat Oncol Biol Phys 53(3):595–599PubMedGoogle Scholar
  23. Chism DB et al (2004) A comparison of the single and double factor high-risk models for risk assignment of prostate cancer treated with 3D conformal radiotherapy. Int J Radiat Oncol Biol Phys 59(2):380–385PubMedGoogle Scholar
  24. Choo R (2010) Salvage radiotherapy for patients with PSA relapse following radical prostatectomy: issues and challenges. Cancer Res Treat 42(1):1–11PubMedCentralPubMedGoogle Scholar
  25. Cimitan M et al (2006) [18F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging 33(12):1387–1398PubMedGoogle Scholar
  26. Connolly JA et al (1996) Local recurrence after radical prostatectomy: characteristics in size, location, and relationship to prostate-specific antigen and surgical margins. Urology 47(2):225–231PubMedGoogle Scholar
  27. Crehange et al (2012) Management of prostate cancer patients with lymph node involvement: a rapidly evolving paradigm. Cancer Treat Rev 38(8):956–967Google Scholar
  28. Czernin J, Allen-Auerbach M, Schelbert HR (2007) Improvements in cancer staging with PET/CT: literature-based evidence as of September 2006. J Nucl Med 48(1):78S–88SPubMedGoogle Scholar
  29. de Jong IJ et al (2002) Visualization of prostate cancer with 11C-choline positron emission tomography. Eur Urol 42(1):18–23PubMedGoogle Scholar
  30. de Jong IJ et al (2003) Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET. J Nucl Med 44(3):331–335PubMedGoogle Scholar
  31. Dehdashti F et al (2005) Positron tomographic assessment of androgen receptors in prostatic carcinoma. Eur J Nucl Med Mol Imaging 32(3):344–350PubMedGoogle Scholar
  32. Deliveliotis C et al (2007) Diagnostic efficacy of transrectal ultrasound-guided biopsy of the prostatic fossa in patients with rising PSA following radical prostatectomy. World J Urol 25(3):309–313PubMedGoogle Scholar
  33. Even-Sapir E et al (2007) 18F-Fluoride positron emission tomography and positron emission tomography/computed tomography. Semin Nucl Med 37(6):462–469PubMedGoogle Scholar
  34. Farsad M et al (2005) Detection and localization of prostate cancer: correlation of (11)C-choline PET/CT with histopathologic step-section analysis. J Nucl Med 46(10):1642–1649PubMedGoogle Scholar
  35. Fonteyne V et al (2008) Intensity-modulated radiotherapy as primary therapy for prostate cancer: report on acute toxicity after dose escalation with simultaneous integrated boost to intraprostatic lesion. Int J Radiat Oncol Biol Phys 72(3):799–807PubMedGoogle Scholar
  36. Fox JJ, Schoder H, Larson SM (2012) Molecular imaging of prostate cancer. Curr Opin Urol 22(4):320–327PubMedGoogle Scholar
  37. Fox JJ et al (2011) Developing imaging strategies for castration resistant prostate cancer. Acta Oncol 50(1):39–48PubMedCentralPubMedGoogle Scholar
  38. Fricke E et al (2003) Positron emission tomography with 11C-acetate and 18F-FDG in prostate cancer patients. Eur J Nucl Med Mol Imaging 30(4):607–611PubMedGoogle Scholar
  39. Gillies RJ, Robey I, Gatenby RA (2008) Causes and consequences of increased glucose metabolism of cancers. J Nucl Med 49(2):24S–42SPubMedGoogle Scholar
  40. Giovacchini G et al (2008) [(11)C]choline uptake with PET/CT for the initial diagnosis of prostate cancer: relation to PSA levels, tumour stage and anti-androgenic therapy. Eur J Nucl Med Mol Imaging 35(6):1065–1073PubMedGoogle Scholar
  41. Giovacchini G et al (2010) 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 37(6):1106–1116PubMedGoogle Scholar
  42. Giovacchini G et al (2012) 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 37(4):325–331PubMedGoogle Scholar
  43. Grosu AL, Nestle U, Weber WA (2009) How to use functional imaging information for radiotherapy planning. Eur J Cancer 45(1):461–463PubMedGoogle Scholar
  44. Grosu AL, Wiedenmann N, Molls M (2005a) Biological imaging in radiation oncology. Z Med Phys 15(3):141–145PubMedGoogle Scholar
  45. Grosu AL et al (2005b) L-(methyl-11C) methionine positron emission tomography for target delineation in resected high-grade gliomas before radiotherapy. Int J Radiat Oncol Biol Phys 63(1):64–74PubMedGoogle Scholar
  46. Grosu AL et al (2006) 11C-methionine PET improves the target volume delineation of meningiomas treated with stereotactic fractionated radiotherapy. Int J Radiat Oncol Biol Phys 66(2):339–344PubMedGoogle Scholar
  47. Grosu AL et al (2011) An interindividual comparison of O-(2-[18F]fluoroethyl)-L-tyrosine (FET)- and L-[methyl-11C]methionine (MET)-PET in patients with brain gliomas and metastases. Int J Radiat Oncol Biol Phys 81(4):1049–1058PubMedGoogle Scholar
  48. Han M et al (2003) Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol 169(2):517–523PubMedGoogle Scholar
  49. Heidenreich A et al (2008) EAU guidelines on prostate cancer. Eur Urol 53(1):68–80PubMedGoogle Scholar
  50. Heidenreich A et al (2011) EAU guidelines on prostate cancer. Part I: screening, diagnosis, and treatment of clinically localised disease. Actas Urol Esp 35(9):501–514PubMedGoogle Scholar
  51. Hoetjes NJ et al (2010) Partial volume correction strategies for quantitative FDG PET in oncology. Eur J Nucl Med Mol Imaging 37(9):1679–1687PubMedCentralPubMedGoogle Scholar
  52. Husarik DB et al (2008) Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 35(2):253–263PubMedGoogle Scholar
  53. Iorio E et al (2010) Activation of phosphatidylcholine cycle enzymes in human epithelial ovarian cancer cells. Cancer Res 70(5):2126–2135PubMedCentralPubMedGoogle Scholar
  54. Jadvar H (2011) Prostate cancer: PET with 18F-FDG, 18F- or 11C-acetate, and 18F- or 11C-choline. J Nucl Med 52(1):81–89PubMedCentralPubMedGoogle Scholar
  55. Jadvar H et al (2012) Prospective evaluation of 18F-NaF and 18F-FDG PET/CT in detection of occult metastatic disease in biochemical recurrence of prostate cancer. Clin Nucl Med 37(7):637–643PubMedCentralPubMedGoogle Scholar
  56. Jana S, Blaufox MD (2006) Nuclear medicine studies of the prostate, testes, and bladder. Semin Nucl Med 36(1):51–72PubMedGoogle Scholar
  57. Jilg CA et al (2012) Salvage lymph node dissection with adjuvant radiotherapy for nodal recurrence of prostate cancer. J Urol 188(6):2190–2197PubMedGoogle Scholar
  58. Jilg CA et al (2014) Detection of lymph node metastasis in patients with nodal prostate cancer relapse using 18F/11C-choline positron emission tomography/computerized tomography: influence of size of nodal tumor infiltration and accuracy related to lymph node regions. J Urol 192Google Scholar
  59. Kao PF, Chou YH, Lai CW (2008) Diffuse FDG uptake in acute prostatitis. Clin Nucl Med 33(4):308–310PubMedGoogle Scholar
  60. Karavitakis M et al (2011) Tumor focality in prostate cancer: implications for focal therapy. Nat Rev Clin Oncol 8(1):48–55PubMedGoogle Scholar
  61. Kato T et al (2002) Accumulation of [11C]acetate in normal prostate and benign prostatic hyperplasia: comparison with prostate cancer. Eur J Nucl Med Mol Imaging 29(11):1492–1495PubMedGoogle Scholar
  62. Kelloff GJ, Choyke P, Coffey DS (2009) Challenges in clinical prostate cancer: role of imaging. AJR Am J Roentgenol 192(6):1455–1470PubMedCentralPubMedGoogle Scholar
  63. Kirste S, Volegova-Neher N, Henne K, Knippen S, Rischke HC, Schäfer AO (2011) Dose escalated radiotherapy of macroscopic local recurrence after radiacal prostatectomy. Strahlenther Onkol 187(1):112Google Scholar
  64. Kotzerke J et al (2000) Experience with carbon-11 choline positron emission tomography in prostate carcinoma. Eur J Nucl Med 27(9):1415–1419PubMedGoogle Scholar
  65. Kotzerke J et al (2002) Carbon-11 acetate positron emission tomography can detect local recurrence of prostate cancer. Eur J Nucl Med Mol Imaging 29(10):1380–1384PubMedGoogle Scholar
  66. Kotzerke J et al (2003) Intraindividual comparison of [11C]acetate and [11C]choline PET for detection of metastases of prostate cancer. Nuklearmedizin 42(1):25–30PubMedGoogle Scholar
  67. Krause BJ, Souvatzoglou M, Treiber U (2013) Imaging of prostate cancer with PET/CT and radioactively labeled choline derivates. Urol Oncol 31(4):427–435Google Scholar
  68. Krause BJ et al (2008) 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 35(1):18–23PubMedGoogle Scholar
  69. Kwee SA et al (2006) Localization of primary prostate cancer with dual-phase 18F-fluorocholine PET. J Nucl Med 47(2):262–269PubMedGoogle Scholar
  70. Kwee SA et al (2008) Use of step-section histopathology to evaluate 18F-fluorocholine PET sextant localization of prostate cancer. Mol Imaging 7(1):12–20PubMedGoogle Scholar
  71. Langsteger W et al (2011) Fluorocholine (18F) and sodium fluoride (18F) PET/CT in the detection of prostate cancer: prospective comparison of diagnostic performance determined by masked reading. Q J Nucl Med Mol Imaging 55(4):448–457PubMedGoogle Scholar
  72. Larson SM et al (2004) Tumor localization of 16beta-18F-fluoro-5alpha-dihydrotestosterone versus 18F-FDG in patients with progressive, metastatic prostate cancer. J Nucl Med 45(3):366–373PubMedGoogle Scholar
  73. Lawrentschuk N et al (2006) Positron emission tomography and molecular imaging of the prostate: an update. BJU Int 97(5):923–931PubMedGoogle Scholar
  74. Lindhe O et al (2009) [(18)F]Fluoroacetate is not a functional analogue of [(11)C]acetate in normal physiology. Eur J Nucl Med Mol Imaging 36(9):1453–1459PubMedGoogle Scholar
  75. Liu Y (2006) Fatty acid oxidation is a dominant bioenergetic pathway in prostate cancer. Prostate Cancer Prostatic Dis 9(3):230–234PubMedGoogle Scholar
  76. Liu A et al (1992) Fluorine-18-labeled androgens: radiochemical synthesis and tissue distribution studies on six fluorine-substituted androgens, potential imaging agents for prostatic cancer. J Nucl Med 33(5):724–734PubMedGoogle Scholar
  77. Liu IJ et al (2001) Fluorodeoxyglucose positron emission tomography studies in diagnosis and staging of clinically organ-confined prostate cancer. Urology 57(1):108–111PubMedGoogle Scholar
  78. Lonsdale MN, Beyer T (2010) Dual-modality PET/CT instrumentation-today and tomorrow. Eur J Radiol 73(3):452–460PubMedGoogle Scholar
  79. Lu-Yao GL, Yao SL (1997) Population-based study of long-term survival in patients with clinically localised prostate cancer. Lancet 349(9056):906–910PubMedGoogle Scholar
  80. MacDonald OK et al (2004) Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: do outcomes differ? Urology 64(4):760–764PubMedGoogle Scholar
  81. Macheda ML, Rogers S, Best JD (2005) Molecular and cellular regulation of glucose transporter (GLUT) proteins in cancer. J Cell Physiol 202(3):654–662PubMedGoogle Scholar
  82. Martorana G et al (2006) 11C-choline positron emission tomography/computerized tomography for tumor localization of primary prostate cancer in comparison with 12-core biopsy. J Urol 176(3):954–960 (discussion)Google Scholar
  83. Meirelles GS et al (2010) Prognostic value of baseline [18F] fluorodeoxyglucose positron emission tomography and 99mTc-MDP bone scan in progressing metastatic prostate cancer. Clin Cancer Res 16(24):6093–6099PubMedCentralPubMedGoogle Scholar
  84. Minamimoto R et al (2011) The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level. Ann Nucl Med 25(1):21–27PubMedGoogle Scholar
  85. Morris AD et al (2001) The value of external beam radiation of nodal positive prostate cancer: a multivariate analysis. Urol Oncol 6(6):255–260Google Scholar
  86. Morris MJ et al (2002) Fluorinated deoxyglucose positron emission tomography imaging in progressive metastatic prostate cancer. Urology 59(6):913–918PubMedGoogle Scholar
  87. Mottet N et al (2011) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Actas Urol Esp 35(10):565–579PubMedGoogle Scholar
  88. Naya Y et al (2005) Efficacy of prostatic fossa biopsy in detecting local recurrence after radical prostatectomy. Urology 66(2):350–355PubMedGoogle Scholar
  89. Nestle U et al (2009) Biological imaging in radiation therapy: role of positron emission tomography. Phys Med Biol 54(1):R1–R25PubMedGoogle Scholar
  90. Niyazi M et al (2010) Choline PET based dose-painting in prostate cancer–modelling of dose effects. Radiat Oncol 5:23PubMedCentralPubMedGoogle Scholar
  91. Nunez R et al (2002) Combined 18F-FDG and 11C-methionine PET scans in patients with newly progressive metastatic prostate cancer. J Nucl Med 43(1):46–55PubMedGoogle Scholar
  92. Ohri N et al (2012) Can early implementation of salvage radiotherapy for prostate cancer improve the therapeutic ratio? A systematic review and regression meta-analysis with radiobiological modelling. Eur J Cancer 48(6):837–844Google Scholar
  93. Oyama N et al (2002) Prognostic value of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography imaging for patients with prostate cancer. Mol Imaging Biol 4(1):99–104PubMedGoogle Scholar
  94. Pandit-Taskar N et al (2008) Antibody mass escalation study in patients with castration-resistant prostate cancer using 111In-J591: lesion detectability and dosimetric projections for 90Y radioimmunotherapy. J Nucl Med 49(7):1066–1074PubMedCentralPubMedGoogle Scholar
  95. Pelosi E et al (2008) Role of whole-body 18F-choline PET/CT in disease detection in patients with biochemical relapse after radical treatment for prostate cancer. Radiol Med 113(6):895–904PubMedGoogle Scholar
  96. Pflug BR et al (2003) Increased fatty acid synthase expression and activity during progression of prostate cancer in the TRAMP model. Prostate 57(3):245–254PubMedGoogle Scholar
  97. Picchio M, Giovannini E, Messa C (2011a) The role of PET/computed tomography scan in the management of prostate cancer. Curr Opin Urol 21(3):230–236PubMedGoogle Scholar
  98. Picchio M et al (2003) Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]fluorodeoxyglucose-positron emission tomography. J Urol 169(4):1337–1340PubMedGoogle Scholar
  99. Picchio M et al (2011b) 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 59(1):51–60PubMedGoogle Scholar
  100. Pieterman RM et al (2002) Comparison of (11)C-choline and (18)F-FDG PET in primary diagnosis and staging of patients with thoracic cancer. J Nucl Med 43(2):167–172PubMedGoogle Scholar
  101. Pinkawa M et al (2012) Dose-escalation using intensity-modulated radiotherapy for prostate cancer—evaluation of quality of life with and without (18)F-choline PET-CT detected simultaneous integrated boost. Radiat Oncol 7:14PubMedCentralPubMedGoogle Scholar
  102. Polascik TJ, Oesterling JE, Partin AW (1999) Prostate specific antigen: a decade of discovery–what we have learned and where we are going. J Urol 162(2):293–306PubMedGoogle Scholar
  103. Ponde DE et al (2007) 18F-fluoroacetate: a potential acetate analog for prostate tumor imaging–in vivo evaluation of 18F-fluoroacetate versus 11C-acetate. J Nucl Med 48(3):420–428PubMedGoogle Scholar
  104. Poulsen MH et al (2012) [18F]fluoromethylcholine (FCH) positron emission tomography/computed tomography (PET/CT) for lymph node staging of prostate cancer: a prospective study of 210 patients. BJU Int 110(11):1666–1671Google Scholar
  105. Rapisarda E et al (2010) Image-based point spread function implementation in a fully 3D OSEM reconstruction algorithm for PET. Phys Med Biol 55(14):4131–4151PubMedGoogle Scholar
  106. Reske SN, Blumstein NM, Glatting G (2008) [11C]choline PET/CT imaging in occult local relapse of prostate cancer after radical prostatectomy. Eur J Nucl Med Mol Imaging 35(1):9–17PubMedGoogle Scholar
  107. Reske SN et al (2006) Imaging prostate cancer with 11C-choline PET/CT. J Nucl Med 47(8):1249–1254PubMedGoogle Scholar
  108. Rigatti P et al (2011) Pelvic/retroperitoneal salvage lymph node dissection for patients treated with radical prostatectomy with biochemical recurrence and nodal recurrence detected by [11C]choline positron emission tomography/computed tomography. Eur Urol 60(5):935–943PubMedGoogle Scholar
  109. Rinnab L et al (2007) Evaluation of [11C]-choline positron-emission/computed tomography in patients with increasing prostate-specific antigen levels after primary treatment for prostate cancer. BJU Int 100(4):786–793PubMedGoogle Scholar
  110. Rischke HC et al (2012a) Correlation of the genotype of paragangliomas and pheochromocytomas with their metabolic phenotype on 3,4-dihydroxy-6-18F-fluoro-L-phenylalanin PET. J Nucl Med 53(9):1352–1358PubMedGoogle Scholar
  111. Rischke HC et al (2012b) Treatment of recurrent prostate cancer following radical prostatectomy: the radiation-oncologists point of view. Q J Nucl Med Mol Imaging 56(5):409–420PubMedGoogle Scholar
  112. Rischke HC et al (2012c) Detection of local recurrent prostate cancer after radical prostatectomy in terms of salvage radiotherapy using dynamic contrast enhanced-MRI without Endorectal coil. Radiat Oncol 7(1):185PubMedCentralPubMedGoogle Scholar
  113. Saleem MD et al (1998) Factors predicting cancer detection in biopsy of the prostatic fossa after radical prostatectomy. Urology 51(2):283–286PubMedGoogle Scholar
  114. Salminen E et al (2002) Investigations with FDG-PET scanning in prostate cancer show limited value for clinical practice. Acta Oncol 41(5):425–429PubMedGoogle Scholar
  115. Scattoni V et al (2004) Diagnosis of local recurrence after radical prostatectomy. BJU Int 93(5):680–688PubMedGoogle Scholar
  116. Scattoni V et al (2007) 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 52(2):423–429PubMedGoogle Scholar
  117. Scher HI, Heller G (2000) Clinical states in prostate cancer: toward a dynamic model of disease progression. Urology 55(3):323–327PubMedGoogle Scholar
  118. Scher B et al (2007) Value of 11C-choline PET and PET/CT in patients with suspected prostate cancer. Eur J Nucl Med Mol Imaging 34(1):45–53PubMedGoogle Scholar
  119. Schiavina R et al (2008) 11C-choline positron emission tomography/computerized tomography for preoperative lymph-node staging in intermediate-risk and high-risk prostate cancer: comparison with clinical staging nomograms. Eur Urol 54(2):392–401PubMedGoogle Scholar
  120. Sciarra A et al (2008) Role of dynamic contrast-enhanced magnetic resonance (MR) imaging and proton MR spectroscopic imaging in the detection of local recurrence after radical prostatectomy for prostate cancer. Eur Urol 54(3):589–600PubMedGoogle Scholar
  121. Sella T et al (2004) Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 231(2):379–385PubMedGoogle Scholar
  122. Seltzer MA et al (2004) Radiation dose estimates in humans for (11)C-acetate whole-body PET. J Nucl Med 45(7):1233–1236PubMedGoogle Scholar
  123. Shekarriz B et al (1999) Vesicourethral anastomosis biopsy after radical prostatectomy: predictive value of prostate-specific antigen and pathologic stage. Urology 54(6):1044–1048PubMedGoogle Scholar
  124. Shreve PD et al (1996) Metastatic prostate cancer: initial findings of PET with 2-deoxy-2-[F-18]fluoro-D-glucose. Radiology 199(3):751–756PubMedGoogle Scholar
  125. Smith TA (2000) Mammalian hexokinases and their abnormal expression in cancer. Br J Biomed Sci 57(2):170–178PubMedGoogle Scholar
  126. Souvatzoglou M et al (2011) The sensitivity of [11C]choline PET/CT to localize prostate cancer depends on the tumor configuration. Clin Cancer Res 17(11):3751–3759PubMedGoogle Scholar
  127. Strope SA, Andriole GL (2010) Prostate cancer screening: current status and future perspectives. Nat Rev Urol 7(9):487–493PubMedGoogle Scholar
  128. Sutinen E et al (2004) Kinetics of [(11)C]choline uptake in prostate cancer: a PET study. Eur J Nucl Med Mol Imaging 31(3):317–324PubMedGoogle Scholar
  129. Symon Z et al (2006) Radiation rescue for biochemical failure after surgery for prostate cancer: predictive parameters and an assessment of contemporary predictive models. Am J Clin Oncol 29(5):446–450PubMedGoogle Scholar
  130. Testa C et al (2007) Prostate cancer: sextant localization with MR imaging, MR spectroscopy, and 11C-choline PET/CT. Radiology 244(3):797–806PubMedGoogle Scholar
  131. Thorwarth D et al (2012) Integration of FDG-PET/CT into external beam radiation therapy planning: technical aspects and recommendations on methodological approaches. Nuklearmedizin 51(4):140–153PubMedGoogle Scholar
  132. Tilki D et al (2013) 18F-Fluoroethylcholine PET/CT identifies lymph node metastasis in patients with prostate-specific antigen failure after radical prostatectomy, but underestimates its extent. Eur Urol 63:792–796 Google Scholar
  133. Toth G et al (2005) Detection of prostate cancer with 11C-methionine positron emission tomography. J Urol 173(1):66–69 (discussion)Google Scholar
  134. Townsend DW (2008) Multimodality imaging of structure and function. Phys Med Biol 53(4):R1–R39PubMedGoogle Scholar
  135. Tuncel M et al (2008) [(11)C]Choline positron emission tomography/computed tomography for staging and restaging of patients with advanced prostate cancer. Nucl Med Biol 35(6):689–695PubMedGoogle Scholar
  136. Turkbey B et al (2009) Imaging localized prostate cancer: current approaches and new developments. AJR Am J Roentgenol 192(6):1471–1480PubMedCentralPubMedGoogle Scholar
  137. van Lin EN et al (2006) IMRT boost dose planning on dominant intraprostatic lesions: gold marker-based three-dimensional fusion of CT with dynamic contrast-enhanced and 1H-spectroscopic MRI. Int J Radiat Oncol Biol Phys 65(1):291–303PubMedGoogle Scholar
  138. Vavere AL et al (2008) 1-11C-acetate as a PET radiopharmaceutical for imaging fatty acid synthase expression in prostate cancer. J Nucl Med 49(2):327–334PubMedGoogle Scholar
  139. Vees H et al (2007) 18F-choline and/or 11C-acetate positron emission tomography: detection of residual or progressive subclinical disease at very low prostate-specific antigen values (<1 ng/ml) after radical prostatectomy. BJU Int 99(6):1415–1420PubMedGoogle Scholar
  140. Viani GA, Stefano EJ, Afonso SL (2009) Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials. Int J Radiat Oncol Biol Phys 74(5):1405–1418PubMedGoogle Scholar
  141. Wurschmidt F et al (2011) [18F]fluoroethylcholine-PET/CT imaging for radiation treatment planning of recurrent and primary prostate cancer with dose escalation to PET/CT-positive lymph nodes. Radiat Oncol 6:44PubMedCentralPubMedGoogle Scholar
  142. Yakar D et al (2012) Predictive value of MRI in the localization, staging, volume estimation, assessment of aggressiveness, and guidance of radiotherapy and biopsies in prostate cancer. J Magn Reson Imaging 35(1):20–31PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Radiation OncologyMedical University of FreiburgFreiburgGermany
  2. 2.Department of Nuclear MedicineMedical University of FreiburgFreiburgGermany

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