Significance of 18F-fluorocholine PET/CT positive pulmonary lesions in prostate cancer patients

• Published in: Nuclear medicine Vol. 54; no. 5; p. 211
• Main Authors: Rager, O, Baskin, A, Amzalag, G, Buchegger, F, Miralbell, R, Ratib, O, Zilli, T, Garibotto, V
• Format: Journal Article
• Language: English
• Published: Germany 2015
• Subjects: Aged; Choline - analogs & derivatives; Comorbidity; Humans; Incidence; Incidental Findings; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Male; Multimodal Imaging - statistics & numerical data; Neoplasms, Multiple Primary - diagnosis; Neoplasms, Multiple Primary - epidemiology; Positron-Emission Tomography - statistics & numerical data; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - epidemiology; Radiopharmaceuticals; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Switzerland - epidemiology; Tomography, X-Ray Computed - statistics & numerical data; Switzerland; lung cancer; prostate cancer; pulmonary metastases; 18F-Fluorocholine; PET/CT
• ISSN: 0029-5566
• DOI: 10.3413/Nukmed-0737-15-04

To assess the frequency and the significance of incidental pulmonary lesions with 18F-fluorocholine (18F-FCH) PET/CT in prostate cancer (PCa) patients. 225 consecutive PCa patients referred for 18F-FCH PET/CT (median age 68 years) were retrospectively evaluated for the presence of lesions in the lungs: 173 referred for restaging and 52 for initial staging regarding their high risk of extra prostatic extension. The final diagnosis was based on histopathological or on clinical and radiological follow-up. 13 patients had 18F-FCH positive pulmonary and 8 patients malignant lesions: 5 patients (38%) had a primary lung cancer (2 squamous cell carcinomas, 1 papillary adenocarcinoma, 1 typical pulmonary carcinoid, 1 bronchioloalveolar carcinoma) and 3 patients (23%) PCa metastases. Benign lesions were found in 5 subjects (38%). SUVmax and maximum diameter were neither significantly different in primary and metastatic tumors nor between malignant and benign lesions. Although our results suggest that incidental uptake in the lungs in PCa patients are nonspecific, their detection may have a significant impact on patient management knowing that more than 60% represent malignant disease.