Role of 11C-choline PET/CT in the re-staging of prostate cancer patients with biochemical relapse and negative results at bone scintigraphy

• Published in: European journal of radiology 2012-08, Vol.81 (8), p.e893-e896
• Main Authors: Fuccio, Chiara, Castellucci, Paolo, Schiavina, Riccardo, Guidalotti, Pier Luigi, Gavaruzzi, Gilberto, Montini, Gian Carlo, Nanni, Cristina, Marzola, Maria Cristina, Rubello, Domenico, Fanti, Stefano
• Format: Article
• Language: English
• Subjects: 11C-choline; Aged; Aged, 80 and over; Biomarkers, Tumor - blood; Bone and Bones - diagnostic imaging; Bone scan; Carbon Radioisotopes; Choline; Humans; Male; Middle Aged; Multimodal Imaging - methods; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Positron emission tomography (PET); Positron-Emission Tomography; Prostate cancer; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - pathology; PSA; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2012.04.027

to evaluate the utility of 11C-choline PET/CT in prostate cancer (PC) patients who have demonstrated a biochemical recurrence and a negative bone scintigraphy (BS). 123 consecutive PC patients (mean age 67.6 years; range 54–83) with a biochemical relapse (mean PSA value 3.3ng/mL; range 0.2–25.5) after radical prostatectomy (RP) were included in our retrospective study. Patients underwent a BS that resulted negative and a 11C-choline PET/CT within 4 months from BS (range: 1 day to 4 months; mean: 2.5 months). Validation of results was established by: (1) a positive biopsy, (2) a positive subsequent BS, CT or MR and (3) a normalization of 11C-choline uptake after systemic therapy or a progression of the disease. 11C-choline PET/CT was positive in 42/123 patients (34.1%). 11C-choline PET/CT detected lesions in: bone (10 patients), lymph-nodes (20 patients), bone and lymph nodes (7 patients), bone and lung (1 patient), lymph-nodes and lung (1 patient), local relapse (3 patients). Overall, 11C-choline PET/CT showed a total of 30 unknown bone lesions in 18/123 (14.6%) patients. 11C-choline PET/CT showed a better sensitivity than BS in patients with biochemical relapse after RP: 11C-choline PET/CT detected unknown bone lesions in 18/123 (14.6%) patients.