Effectiveness of 11 C-choline PET/CT in prostate cancer surveillance

• Published in: Revista Española de medicina nuclear e imagen molecular (English ed.) Vol. 42; no. 2; p. 93
• Main Authors: Martínez-Rodríguez, I, de Arcocha-Torres, M, Gómez-de la Fuente, F J, Jiménez-Bonilla, J, Sánchez-Salmón, A, Martínez-Amador, N, Mendi-Barcina, V, Andrés-Pacheco, J, Gutiérrez-González, A, Pombo-López, M, Bota-Bota, A, Rodil-Gallego, M, García-Ruiz, A, Quirce, R
• Format: Journal Article
• Language: English
• Published: Spain 01.03.2023
• Subjects: Aged; Carbon Radioisotopes; Choline; Humans; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Prostate-Specific Antigen; Prostatic Neoplasms; Retrospective Studies; Antígeno prostático específico; Cáncer de próstata; Prostate specific antigen; C-colina; PET/CT; Recaída bioquímica; C-choline; PET/TC; Biochemical recurrence; Prostate cancer
• ISSN: 2253-8089

Our aim was to analyse the performance of [ C]choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/mL. Three hundred and twenty-nine [ C]choline PET/CT examinations from 191 patients (68.2 ± 7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated. PSA at study was 13.0 ± 84.2 ng/mL. Main initial treatment was radical prostatectomy (RP) in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20' after injection of 555-740 MBq of [ C]choline. Minimum follow-up was 12 months. Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than RP compared to patients with RP (85.6% vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 [ C]choline PET/CT scans performed with PSA < 1 ng/mL, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. [ C]choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA < 1 ng/mL. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment.