Effect of positive carbon-11-choline PET/CT results in the therapeutic management of prostate cancer biochemical relapse

• Published in: Nuclear medicine communications Vol. 40; no. 1; pp. 79 - 85
• Main Authors: Gómez-de la Fuente, Francisco J, Martínez-Rodríguez, Isabel, De Arcocha-Torres, Maria, Quirce, Remedios, Jiménez-Bonilla, Julio, Martínez-Amador, Néstor, Sánchez-Salmón, Aida, Lucas-Velázquez, Blanca, Cuenca-Vera, Oriana, Banzo, Ignacio
• Format: Journal Article
• Language: English
• Published: England Copyright Wolters Kluwer Health, Inc. All rights reserved 01-01-2019; Lippincott Williams & Wilkins
• Subjects: Aged; Aged, 80 and over; Carbon Radioisotopes; Choline; Humans; Male; Middle Aged; Original; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - metabolism; Prostatic Neoplasms - therapy; Recurrence; Retrospective Studies
• ISSN: 0143-3636; 1473-5628
• DOI: 10.1097/MNM.0000000000000936

OBJECTIVECarbon-11-(C)-choline PET/computed tomography (CT) has shown good results in re-staging of prostate cancer (PCa) with raised serum levels of prostate-specific antigen. Our aim was to evaluate the effect of positive C-choline PET/CT results in the therapeutic management of patients with PCa with biochemical relapse (BR) after curative intention treatment.
PATIENTS AND METHODSA total of 112 patients with PCa BR and positive C-choline PET/CT were retrospectively evaluated. PET/CT was acquired 20 min after intravenous administration of 555–740 MBq of C-choline. The therapeutic management after C-choline PET/CT was obtained from the clinical records. The minimum follow-up time was 18 months.
RESULTSIn 80 (71.4%) of 112 patients, C-choline PET/CT showed local recurrence of PCa; in 17 (15.2%) patients, distant recurrence; and in 15 (13.4%) patients, local plus distant recurrence. A second malignancy was detected in five (4.5%) patients. The planned therapeutic management was changed as per positive C-choline PET/CT result in 74 (66.1%) patients and were treated as follows31 (27.7%) patients with HT, combined with other treatments in eight (7.1%), 17 (15.2%) with BT, 13 (11.6%) with external beam radiotherapy, one (0.9%) with RP, and four (3.6%) with chemotherapy. Treatment approach was not modified in 37 (33%) patients. No data was available from one (0.9%) patient.
CONCLUSIONPositive C-choline PET/CT result had an important effect in the therapeutic management of patients with PCa and BR, leading to a change in the planned approach in two (66.1%) out of three patients. In addition, in 4.5% of the patients, the C-choline PET/CT allowed the detection of a second malignancy.