Impact of total PSA, PSA doubling time and PSA velocity on detection rates of ^sup 11^C-Choline positron emission tomography in recurrent prostate cancer

• Published in: World journal of urology 2013-04, Vol.31 (2), p.319
• Main Authors: Rybalov, Maxim, Breeuwsma, Anthonius J, Leliveld, Anna M, Pruim, Jan, Dierckx, Rudi A, de Jong, Igle J
• Format: Article
• Language: English
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-012-0908-z

To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of ^sup 11^C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT). We included 185 patients with BCR after RP (PSAÂ >0.2Â ng/ml) or after EBRT (ASTRO definition). After injection of 400Â MBq ^sup 11^C-Choline i.v., a scan was made using the ECAT HRÂ +Â PET camera with CT fusion images or Siemens mCT PET/CT. Biopsy-proven histology, confirmative imaging (CT or bone scan) and/or clinical follow-up (PSA) were used as composite reference. Statistical analysis was performed using PASW Statistics 18. ^sup 11^C-Choline PET was positive in 124/185 cases (65Â %) (in 22/61 (36Â %) after RP, 102/124 (82Â %) after EBRT). In 79 patients a local recurrence was identified, and 45 patients showed locoregional metastases on PET/CT. In 20 cases a proven false-negative PET scan was observed. Positive PET scans were confirmed by histology in 87/124 (70Â %) cases, by confirmatory imaging in 34/124 (28Â %) and by clinical follow-up after salvage treatment in 3 (2Â %) cases. The ROC analysis to detect a recurrence showed significant difference in area under the curve (AUC) of tPSA 0.721(pÂ