Skip to main content

Advertisement

SpringerLink
Log in

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To investigate the clinical value of 18F-fluorocholine PET/CT (CH-PET/CT) in treatment decisions in patients with recurrent prostate cancer (rPCA).

Methods

The study was a retrospective evaluation of 156 patients with rPCA and CH-PET/CT for restaging. Questionnaires for each examination were sent to the referring physicians 14–64 months after examination. Questions included information regarding initial extent of disease, curative first-line treatment, and the treatment plan before and after CH-PET/CT. Additionally, PSA values at diagnosis, after initial treatment, before CH-PET/CT and at the end of follow-up were also obtained from the questionnaires.

Results

Mean follow-up was 42 months. The mean Gleason score was 6.9 at initial diagnosis. Initial treatment was: radical prostatectomy in 110 patients, radiotherapy in 39, and combined prostatectomy and radiotherapy in 7. Median PSA values before CH-PET/CT and at the end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, decreased or were below measurable levels in 108 patients. PSA levels increased in 48 patients. In 75 of the 156 patients (48%) the treatment plan was changed due to the CH-PET/CT findings. In 33 patients the therapeutic plan was changed from palliative treatment to treatment with curative intent. In 15 patients treatment was changed from curative to palliative. In 8 patients treatment was changed from curative to another strategy and in 2 patients from one palliative strategy to another. In 17 patients the treatment plan was adapted.

Conclusion

CH-PET/CT has an important impact on the therapeutic strategy in patients with rPCA and can help to determine an appropriate treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90. doi:10.3322/caac.20107.

    Article  PubMed  Google Scholar 

  2. Lu-Yao GL, Potosky AL, Albertsen PC, Wasson JH, Barry MJ, Wennberg JE. Follow-up prostate cancer treatments after radical prostatectomy: a population-based study. J Natl Cancer Inst. 1996;88:166–73.

    Article  PubMed  CAS  Google Scholar 

  3. Bott SR. Management of recurrent disease after radical prostatectomy. Prostate Cancer Prostatic Dis. 2004;7:211–6. doi:10.1038/sj.pcan.45007324500732.

    Article  PubMed  CAS  Google Scholar 

  4. Fowler Jr FJ, Barry MJ, Lu-Yao G, Roman A, Wasson J, Wennberg JE. Patient-reported complications and follow-up treatment after radical prostatectomy. The National Medicare Experience: 1988-1990 (updated June 1993). Urology. 1993;42:622–9.

    Article  PubMed  Google Scholar 

  5. Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC, et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 2005;294:433–9. doi:10.1001/jama.294.4.433.

    Article  PubMed  CAS  Google Scholar 

  6. Mottet N, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part II: Treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol. 2011;59:572–83. doi:10.1016/j.eururo.2011.01.025.

    Article  PubMed  Google Scholar 

  7. Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59:61–71. doi:10.1016/j.eururo.2010.10.039.

    Article  PubMed  Google Scholar 

  8. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology, prostate cancer. 2010. Fort Washington: National Comprehensive Cancer Network

  9. Schmid DT, John H, Zweifel R, Cservenyak T, Westera G, Goerres GW, et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology. 2005;235:623–8. doi:10.1148/radiol.2352040494.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

  11. Fanti S, Krause B, Weber W, Castellucci P, Grosu AL, de Jong IJ, et al. Re: Nicolas Mottet, Joaquim Bellmunt, Michel Bolla, et al. EAU guidelines on prostate cancer. Part II: Treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol 2011;59:572-83. Eur Urol. 2011;60:e37–8; author reply e39–41. doi:10.1016/j.eururo.2011.08.009

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. 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.

    Article  PubMed  CAS  Google Scholar 

  14. Husarik DB, Miralbell R, Dubs M, John H, Giger OT, Gelet A, et al. Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging. 2008;35:253–63. doi:10.1007/s00259-007-0552-9.

    Article  PubMed  Google Scholar 

  15. Heinisch M, Dirisamer A, Loidl W, Stoiber F, Gruy B, Haim S, et al. Positron emission tomography/computed tomography with F-18-fluorocholine for restaging of prostate cancer patients: meaningful at PSA <5 ng/ml? Mol Imaging Biol. 2006;8:43–8. doi:10.1007/s11307-005-0023-2.

    Article  PubMed  Google Scholar 

  16. Castellucci P, Fuccio C, Rubello D, Schiavina R, Santi I, Nanni C, et al. Is there a role for 11C-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.

    Article  PubMed  Google Scholar 

  17. Souvatzoglou M, Krause BJ, Purschel A, Thamm R, Schuster T, Buck AK, et al. Influence of (11)C-choline PET/CT on the treatment planning for salvage radiation therapy in patients with biochemical recurrence of prostate cancer. Radiother Oncol. 2011;99:193–200. doi:10.1016/j.radonc.2011.05.005.

    Article  PubMed  Google Scholar 

  18. Wurschmidt F, Petersen C, Wahl A, Dahle J, Kretschmer M. [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. 2011;6:44. doi:10.1186/1748-717X-6-44.

    Article  PubMed  Google Scholar 

  19. Rigatti P, Suardi N, Briganti A, Da Pozzo LF, Tutolo M, Villa L, et al. 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. 2011;60:935–43. doi:10.1016/j.eururo.2011.07.060.

    Article  PubMed  Google Scholar 

  20. Kwee SA, Wei H, Sesterhenn I, Yun D, Coel MN. Localization of primary prostate cancer with dual-phase 18F-fluorocholine PET. J Nucl Med. 2006;47:262–9.

    PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Jan D. Soyka, Marco A. Muster, Daniel T. Schmid, Patrick Veit-Haibach, Klaus Strobel, Niklaus G. Schaefer & Thomas F. Hany

  2. Division of Biostatistics, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland

    Burkhardt Seifert

  3. Department of Radiation-Oncology, University Hospital Geneva, Geneva, Switzerland

    Ulrike Schick & Raymond Miralbell

  4. Department of Radiation-Oncology, Instituto Oncológico Teknon, Barcelona, Spain

    Sandra Jorcano

  5. Department of Radiation-Oncology, University Hospital Zurich, Zurich, Switzerland

    Kathrin Zaugg

  6. Department of Urology, University Hospital Zurich, Zurich, Switzerland

    Hans-Helge Seifert

  7. Department of Radiology, University Hospital Zurich, Zurich, Switzerland

    Daniela B. Husarik

Authors
  1. Jan D. Soyka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marco A. Muster
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel T. Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Burkhardt Seifert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ulrike Schick
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Raymond Miralbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sandra Jorcano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kathrin Zaugg
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hans-Helge Seifert
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Patrick Veit-Haibach
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Klaus Strobel
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Niklaus G. Schaefer
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Daniela B. Husarik
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Thomas F. Hany
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan D. Soyka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Soyka, J.D., Muster, M.A., Schmid, D.T. et al. Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer. Eur J Nucl Med Mol Imaging 39, 936–943 (2012). https://doi.org/10.1007/s00259-012-2083-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-012-2083-2

Keywords

Search

Navigation