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Role of carbon-11 choline PET/CT in the management of uterine carcinoma: initial experience

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Abstract

Purpose

The present study was conducted to clarify the role of carbon-11 choline (11C-choline) positron emission tomography (PET)/computed tomography (CT) in the management of uterine carcinoma.

Materials and methods

Twenty-two patients who underwent 11C-choline PET/CT and pelvic MRI were evaluated retrospectively. The images were reviewed by a board-certified radiologist and a nuclear medicine specialist who were unaware of any clinical information, and a consensus was reached. Diagnostic accuracy of PET/CT was evaluated for staging. The reference standard consisted of histological examination (n = 17) and follow-up conventional CT (n = 5). In five patients with cervical carcinoma, 11C-choline PET/CT was performed before and after treatment that consisted of cisplatin infusion and subsequent radiotherapy. Standardized uptake value (SUV) was compared with uni-dimensional and volumetric measurements that were made on magnetic resonance images (MRI) before and after treatment.

Results

Based on PET/CT interpretations, the reviewers correctly classified T stage in 8 patients (47%), N stage in 21 patients (96%), M stage in 20 patients (91%), and TNM stage in 15 patients (88%). Tumor size, volume, and SUV decreased after treatment in five patients with cervical carcinoma. Using the Pearson correlation test, a significant correlation was found between the reduction rate of SUV and reduction rate of tumor volume.

Conclusions

11C-choline PET/CT is an accurate means for the management of patients with uterine carcinoma. The combination of 11C-choline PET/CT and MRI increases the accuracy of staging in patients with uterine carcinoma.

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References

  1. Hara T, Kosaka N, Shinoura N, Kondo T. PET imaging of brain tumor with [methyl-11C]choline. J Nucl Med. 1997;38:842–7.

    PubMed  CAS  Google Scholar 

  2. Hara T, Kosaka N, Kishi H. PET imaging of prostate cancer using carbon-11-choline. J Nucl Med. 1998;39:990–5.

    PubMed  CAS  Google Scholar 

  3. Jager PL, Que TH, Vaalburg W, Prium J, Elsinga P, Plukker JT. Carbon-11 choline or FDG-PET for staging of oesophageal cancer? Eur J Nucl Med. 2001;28:1845–9.

    Article  PubMed  CAS  Google Scholar 

  4. Pieterman RM, Que TH, Elsinga PH, Pruim J, van Putten JW, Willemsen AT, et al. (11)C-choline and (18)F-FDG PET in primary diagnosis and staging of patients with thoracic cancer. J Nucl Med. 2002;43:167–72.

    PubMed  Google Scholar 

  5. de Jong IJ, Prium J, Elsinga PH, Vaalburg W, Mensink HJ. Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET. J Nucl Med. 2003;44:331–5.

    PubMed  Google Scholar 

  6. Picchio M, Treiber U, Beer AJ, Metz S, Bossner P, van Randenborgh H, et al. Value of 11C-choline PET and contrast-enhanced CT for staging of bladder cancer: correlation with histopathologic findings. J Nucl Med. 2006;47:938–44.

    PubMed  CAS  Google Scholar 

  7. Tian M, Zhang H, Oriuchi N, Higuchi T, Endo K. Comparison of 11C-choline PET and FDG PET for the differential diagnosis of malignant tumors. Eur J Nucl Med Mol Imaging. 2004;31:1064–72.

    PubMed  CAS  Google Scholar 

  8. Scher B, Seitz M, Albinger W, Tiling R, Scherr M, Becker HC, et al. Value of (11)C-choline PET and PET/CT in patients with suspected prostate cancer. Eur J Nucl Med Mol Imaging. 2007;34:45–53.

    Article  PubMed  Google Scholar 

  9. Torizuka T, Kanno T, Futatsubashi M, Okada H, Yoshikawa E, Nakamura F, et al. Imaging of gynecologic tumors: comparison of 11C-choline PET with 18F-FDG PET. J Nucl Med. 2003;44:1051–6.

    PubMed  CAS  Google Scholar 

  10. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16.

    Article  PubMed  CAS  Google Scholar 

  11. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35:1773–82.

    Article  PubMed  CAS  Google Scholar 

  12. Nakamoto Y, Eisbruch A, Achtyes ED, Sugawara Y, Reynolds KR, Johnston CM, et al. Prognostic value of positron emission tomography using F-18-fluorodeoxyglucose in patients with cervical cancer undergoing radiotherapy. Gynecol Oncol. 2002;84:289–95.

    Article  PubMed  Google Scholar 

  13. Grigsby PW, Siegel BA, Dehdashti F, Rader J, Zoberi I. Posttherapy [18F] fluorodeoxyglucose positron emission tomography in carcinoma of the cervix: response and outcome. J Clin Oncol. 2004;22:2167–71.

    Article  PubMed  Google Scholar 

  14. Yoshida Y, Kurokawa T, Kawahara K, Yagihara A, Tsuchida T, Okazawa H, et al. Metabolic monitoring of advanced uterine cervical cancer neoadjuvant chemotherapy by using [F-18]-Fluorodeoxyglucose positron emission tomography: preliminary results in three patients. Gynecol Oncol. 2004;95:597–602.

    Article  PubMed  Google Scholar 

  15. Xue F, Lin LL, Dehdashti F, Miller TR, Siegel BA, Grigsby PW. F-18 fluorodeoxyglucose uptake in primary cervical cancer as an indicator of prognosis after radiation therapy. Gynecol Oncol. 2006;101:147–51.

    Article  PubMed  CAS  Google Scholar 

  16. Bar-Shalom R, Yefremov N, Guralnik L, Gaitini D, Frenkel A, Kuten A, et al. Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med. 2003;44:1200–9.

    PubMed  Google Scholar 

  17. Hara T, Yuasa M. Automated synthesis of [11C]choline, a positron-emitting tracer for tumor imaging. Appl Radiat Isot. 1999;50:531–3.

    Article  PubMed  CAS  Google Scholar 

  18. Sobin LH, Wittekind C. UICC TNM classification of malignant tumours. 6th ed. New York: Wiley; 2002.

    Google Scholar 

  19. Benedet JL, Bender H, Jones H III, Ngan HY, Pecorelli S. FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet. 2000;70:209–62.

    Article  PubMed  CAS  Google Scholar 

  20. Togashi K, Nishimura K, Sagoh T, Minami S, Noma S, Fujisawa I, et al. Carcinoma of the cervix: staging with MR imaging. Radiology. 1989;171:245–51.

    PubMed  CAS  Google Scholar 

  21. Manfredi R, Mirk P, Maresca G, Margariti PA, Testa A, Zannoni GF, et al. Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology. 2004;231:372–8.

    Article  PubMed  Google Scholar 

  22. Grigsby PW, Siegel BA, Dehdashti F. Lymph node staging by positron emission tomography in patients with carcinoma of the cervix. J Clin Oncol. 2001;19:3745–9.

    PubMed  CAS  Google Scholar 

  23. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pelleqrino A, et al. Lymph node metastasis in patients with clinical early-stage cervical cancer: detection with integrated FDG PET/CT. Radiology. 2006;238:272–9.

    Article  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. Gutman F, Aflalo-Hazan V, Kerrou K, Montravers F, Grahek D, Talbot JN. 18F-choline PET/CT for initial staging of advanced prostate cancer. AJR Am J Roentogenol. 2006;187:618–21.

    Article  Google Scholar 

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Acknowledgments

This work was supported in part by grants from Scientific Research Expenses for Health and Welfare Programs and the Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare.

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Authors and Affiliations

  1. Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

    Keitaro Sofue & Yasuaki Arai

  2. Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Ukihide Tateishi & Tomio Inoue

  3. Division of Gynecologic Oncology, National Cancer Center Hospital, Tokyo, Japan

    Morio Sawada

  4. Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan

    Tetsuo Maeda & Kazuro Sugimura

  5. Division of Cancer Screening, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

    Takashi Terauchi & Daisuke Kano

Authors
  1. Keitaro Sofue
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  2. Ukihide Tateishi
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  3. Morio Sawada
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  4. Tetsuo Maeda
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  7. Yasuaki Arai
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  8. Tomio Inoue
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  9. Kazuro Sugimura
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Corresponding author

Correspondence to Ukihide Tateishi.

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Sofue, K., Tateishi, U., Sawada, M. et al. Role of carbon-11 choline PET/CT in the management of uterine carcinoma: initial experience. Ann Nucl Med 23, 235–243 (2009). https://doi.org/10.1007/s12149-009-0230-z

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  • DOI: https://doi.org/10.1007/s12149-009-0230-z

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