Skip to main content
Log in

Role of whole-body 18F-choline PET/CT in disease detection in patients with biochemical relapse after radical treatment for prostate cancer

Ruolo dell’esame PET/TC con 18F-colina nell’identificazione di malattia in pazienti sottoposti a trattamento radicale per neoplasia prostatica, con attuale recidiva biochimica

  • Uro-Genital Radiology Radiologia Uro-Genitale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the role of whole body 18F-choline (FCH) positron emission tomography—computed tomography (PET-CT) in detecting and localising disease recurrence in patients presenting biochemical relapse after radical treatment for prostate cancer.

Materials and methods

Fifty-six consecutive patients with increased serum prostate-specific antigen (PSA) levels after radical prostatectomy were included in the study. None of them was receiving hormone treatment at the time of the examination or had been treated during the previous 6 months. All patients underwent whole-body 18F-choline PET imaging, and the pathological findings were compared with those of further imaging exams, biopsy and follow-up. On the basis of the PSA levels, we divided our patient population into three subgroups: PSA≤1, 1<PSA≤5, and PSA>5 ng/ml.

Results

Overall, the PET scan detected disease relapse in 42.9% of cases (24/56). PET sensitivity was closely related to serum PSA levels, showing values of 20%, 44% and 81.8% in the PSA≤1, 1<PSA≤5 and PSA>5ng/ml subgroups, respectively.

Conclusions

In patients with biochemical relapse after radical treatment for prostate cancer, 18F-choline PET-CT represents a single step, whole-body, noninvasive study that allows disease detection and localisation. The disease detection rate is related to serum PSA levels.

Riassunto

Obiettivo

Lo scopo di questo studio è stato quello di valutare il ruolo dell’esame PET/TC con 18F-colina nella identificazione e localizzazione di recidiva di malattia in pazienti sottoposti a trattamento radicale per neoplasia prostatica, in presenza di attuale recidiva biochimica.

Materiali e metodi

Sono stati inclusi 56 pazienti consecutivi, sottoposti a prostatectomia radicale e con livelli serici di PSA in incremento. Al momento dell’esame, nessuno di loro era in trattamento ormonale né lo era stato nei sei mesi precedenti. Tutti i pazienti sono stati sottoposti ad esame PET/TC total-body con 18F-colina; i reperti patologici sono stati confrontati con ulteriori esami strumentali e/o con la biopsia e/o col follow-up clinico. Sulla base dei livelli serici di PSA, abbiamo suddiviso la nostra popolazione in tre sottogruppi: PSA ≤1, 1<PSA ≤5 e PSA>5 ng/ml.

Risultati

L’esame PET ha identificato la ripresa di malattia nel 42,9% dei casi (24/56). La sensibilità è risultata strettamente correlata ai livelli serici di PSA; infatti essa è stata del 20%, del 44% e dello 81% rispettivamente, nei sottogruppi con PSA ≤1, 1<PSA ≤5 e PSA>5 ng/ml.

Conclusioni

Nei pazienti trattati radicalmente per carcinoma della prostata, in presenza di recidiva biochimica, l’esame PET/TC total-body con 18F-colina rappresenta un’indagine singola e non invasiva, che consente di identificare e localizzare la recidiva di malattia; la sua percentuale di identificazione è correlata con i livelli serici del PSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References/Bibliografia

  1. ESMO (2005) Minimum clinical recommendations for diagnosis, treatment and follow-up of prostate cancer. Ann Oncol 16(Suppl 1):i34–i36

    Article  Google Scholar 

  2. Schoder H, Herrmann K, Gonen M et al (2005) 2-[18F]fluoro-2-deoxiglucose positron emission tomography for the detection of disease in patients with prostate-specific antigen relapse after radical prostatectomy. Clin Cancer Res 11:4761–4769

    Article  PubMed  Google Scholar 

  3. Loblaw D, Mendelson DS, Talcott JA et al (2004) American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol 22:2927–2941

    Article  PubMed  Google Scholar 

  4. Partin AW, Pearson JD, Landis PK et al (1994) Evaluation of serum prostate specific antigen velocity after radical prostatectomy to distinguish local recurrence from distant metastases. Urology 43:649–659

    Article  PubMed  CAS  Google Scholar 

  5. Gambhir SS, Czernin J, Schwimmer J et al (2001) A tabulated summary of the FDG PET literature. J Nuc Med 42(5 Suppl):1S–93S

    CAS  Google Scholar 

  6. DeGrado TR, Baldwin SW, Wang S et al (2001) Synthesis and evaluation of 18F-labeled choline analogs as oncologic PET tracers. J Nucl Med 42:1805–1814

    PubMed  CAS  Google Scholar 

  7. Hara T, Kosaka N, Kishi H (2002) Development of 18F-Fluoroethylcholine for cancer imaging with PET: synthesis, biochemistry, and prostate cancer imaging. J Nucl Med 43:187–199

    PubMed  CAS  Google Scholar 

  8. Jana S, Blaufox MD (2006) Nuclear medicine studies of the prostate, testes, and bladder. Semin Nucl Med 36:51–72

    Article  PubMed  Google Scholar 

  9. Langsteger W, Heinisch M, Fogelman I (2006) The role of fluorodeoxyglucose, 18F-dihydroxyphenylalanine, 18Fcholine, and 18F-fluoride in bone imaging with emphasis on prostate and breast. Semin Nucl Med 36:73–92

    Article  PubMed  Google Scholar 

  10. Schmidt DT, John H, Zweifel R et al (2005) Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 235:623–628

    Article  Google Scholar 

  11. Kwee SA, Wei H, Sesterhenn I et al (2006) Localization of primary prostate cancer with Dual-Phase 18FFluorocholine PET. J Nucl Med 47:262–269

    PubMed  Google Scholar 

  12. Heinisch M, Dirisamer A, Loidl W et al (2006) Positron emission tomography/computed tomography with F-18-fluorocholine for restaging of prostate cancer patients: meaningful at PSA<5 ng/ml? Mol Imaging Biol 8:43–48

    Article  PubMed  Google Scholar 

  13. Cimitan M, Bortolus R, Morassut S et al (2006) [(18)F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging 33:1387–1398

    Article  PubMed  Google Scholar 

  14. Ackerstaff E, Pflug BR, Nelson JB, Bhujwalla ZM (2001) Detection of increased choline compounds with proton nuclear magnetic resonance spectroscopy subsequent to malignant transformation of human prostatic epithelial cells. Cancer Res 61:3599–3603

    PubMed  CAS  Google Scholar 

  15. Sella T, Schwartz LH, Swindle PW et al (2004) Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 231:379–385

    Article  PubMed  Google Scholar 

  16. Pucar D, Shukla-Dave A, Hricak H et al (2005) Prostate cancer: correlation of MR imaging and MR spectroscopy with pathologic findings after radiation therapy — initial experience. Radiology 236:545–553

    Article  PubMed  Google Scholar 

  17. Wefer AE, Hricak H, Vigneron DB et al (2000) Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. J Urol 164:400–404

    Article  PubMed  CAS  Google Scholar 

  18. Coakley FV, The HS, Qayyum A et al (2004) Endorectal MR imaging and MR spectroscopic imaging for locally recurrent prostate cancer after external beam radiation therapy: preliminary experience. Radiology 233:441–448

    Article  PubMed  Google Scholar 

  19. Schoder H, Larson SM (2004) Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med 34:274–292

    Article  PubMed  Google Scholar 

  20. Jadvar H, Pinski JK, Conti PS (2003) FDG-PET in suspected recurrent and metastatic prostate cancer. Oncol Rep 10:1485–1488

    PubMed  Google Scholar 

  21. Albrecht S, Buchegger F, Soloviev D et al (2007) (11)C-acetate PET in the early evaluation of prostate cancer recurrence. Eur J Nucl Med Mol Imaging 34:185–196

    Article  PubMed  Google Scholar 

  22. Morris MJ, Scher HI (2007) (11)Cacetate PET imaging in prostate cancer. Eur J Nucl Med Mol Imaging 34:181–184

    Article  PubMed  Google Scholar 

  23. Sandblom G, Sorensen J, Lundin N et al (2006) Positron emission tomography with C11-Acetate for tumour detection and localization in patients with prostate-specific-antigen relapse after radical prostatectomy. Urology 67:996–1000

    Article  PubMed  Google Scholar 

  24. Hara T, Kosaka N, Kishi H (1998) PET imaging of prostate cancer using carbon-11-choline. J Nucl Med 39:990–995

    PubMed  CAS  Google Scholar 

  25. Picchio M, Messa C, Landoni C et al (2003) Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]Fluorodeoxyglucose-positron emission tomography. J Urol 169:1337–1340

    Article  PubMed  CAS  Google Scholar 

  26. De Jong I, Pruim J, Elsinga PH et al (2003) 11C-choline positron emission tomography for the evaluation after treatment of localized prostate cancer. Eur Urol 44:32–38

    Article  PubMed  Google Scholar 

  27. Yoshida S, Nakagomi K, Goto S et al (2005) 11C-choline positron emission tomography in prostate cancer: primary staging and recurrent site staging. Urol Int 74:214–220

    Article  PubMed  CAS  Google Scholar 

  28. de Jong I, Pruim J, Elsinga PH et al (2003) Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET. J Nucl Med 44:331–335

    PubMed  Google Scholar 

  29. Yamaguchi T, Lee J, Uemura H et al (2005) Prostate cancer: a comparative study of 11C-choline PET and MR imaging combined with proton MR spectroscopy. Eur J Nucl Med Mol Imaging 32:742–748

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Pelosi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pelosi, E., Arena, V., Skanjeti, A. et al. Role of whole-body 18F-choline PET/CT in disease detection in patients with biochemical relapse after radical treatment for prostate cancer. Radiol med 113, 895–904 (2008). https://doi.org/10.1007/s11547-008-0263-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-008-0263-8

Keywords

Parole chiave

Navigation