Combined bone scintigraphy and fluorocholine PET/computed tomography predicts response to radium-223 therapy in patients with prostate cancer

• Published in: Future science OA 2021-09, Vol.7 (8), p.FSO719-FSO719
• Main Authors: Klain, Michele, Gaudieri, Valeria, Petretta, Mario, Zampella, Emilia, Storto, Giovanni, Nappi, Carmela, Buonerba, Carlo, Crocetto, Felice, Gallicchio, Rosj, Volpe, Fabio, Pace, Leonardo, Schlumberger, Martin, Cuocolo, Alberto
• Format: Article
• Language: English
• Subjects: 18F-fluorocholine PET/CT outcome; 223radium; bone scintigraphy; F-fluorocholine PET/CT outcome; prostate cancer; radium
• ISSN: 2056-5623; 2056-5623
• DOI: 10.2144/fsoa-2021-0053

To assess the value of bone scintigraphy and F-fluorocholine PET/computed tomography (CT) in predicting outcome in patients with prostate cancer and bone metastases treated with radium. Retrospective analysis of 48 patients that underwent radium therapy. End points were pain relief and overall survival. After therapy, pain relief was observed in 27 patients. Patients without pain relief had more bone lesions at PET/CT than at bone scintigraphy (pretherapy imaging mismatch). In 39 patients who completed treatment protocol, post-therapy alkaline phosphatase and pretherapy imaging mismatch were independent predictors of poor overall survival. Patients with more lesions at F-fluorocholine PET/CT than at bone scintigraphy had a poor prognosis. The combined imaging approach could be useful to predict outcome after radium therapy. Using a retrospective, two-center cohort of men with prostate cancer (n = 48), this study evaluated the combined assessment of bone scintigraphy and F-fluorocholine PET/CT in predicting response to  radium. Patients with more bone lesions detected by F-fluorocholine PET/CT than bone scintigraphy had less symptomatic benefit and the worst outcome.