Diagnostic utility and therapeutic impact of PET/CT [18F]F-Fluoromethylcholine -Choline in the biochemical recurrence of prostate cancer
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 Sep-Oct;39(5):284-291.
doi: 10.1016/j.remn.2020.03.010.
Epub 2020 May 25.
[Article in
English,
Spanish]
Authors
N Sánchez
1
, I Valduvieco
2
, M J Ribal
3
, F Campos
1
, F Casas
2
, C Nicolau
4
, R Salvador
4
, B Mellado
5
, S Jorcano
2
, D Fuster
6
, P Paredes
7
Affiliations
- 1 Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, España.
- 2 Servicio de Oncología Radioterápica, Hospital Clínic de Barcelona, Barcelona, España.
- 3 Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, España.
- 4 Servicio de Radiodiagnóstico, CDI. Hospital Clínic de Barcelona, Barcelona, España; Facultad de Medicina, Universitat de Barcelona (UB), Barcelona, España.
- 5 Servicio de Oncología Médica, ICMHO. Hospital Clínic de Barcelona, Barcelona, España.
- 6 Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, España; Facultad de Medicina, Universitat de Barcelona (UB), Barcelona, España.
- 7 Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, España; Facultad de Medicina, Universitat de Barcelona (UB), Barcelona, España. Electronic address: pparedes@clinic.cat.
Abstract
Objective:
To assess the diagnostic capability of PET/CT with [18F]F-Fluoromethylcholine in prostate cancer (PC) with biochemical recurrence and its therapeutic impact.
Material and methods:
We included 108 patients, diagnosed with PC with biochemical criteria for recurrence. A PET/CT Choline scan was performed by dynamic pelvic and whole body study at 60min post-tracer injection. The relationship between the positive studies and the PSA value was analysed by classifying patients into three groups (<1.2/1.2-2/>2ng/ml), and the diagnostic capacity was assessed with respect to pelvic MRI and the impact on the therapeutic decision.
Results:
The location of recurrence was identified in 85 of 108 patients (78.7%): 34 local, 47 pelvic lymph nodes and 58 distant lesions, including retroperitoneal, mediastinal lymph nodes and distant organ lesions (bone and lung). Second tumors were diagnosed in 4 patients. No significant differences were found in the percentage of positive studies depending on primary treatment. Patients with PSA>2ng/ml showed a higher percentage of disease detection than patients with a lower PSA level, with significant differences (p<0.0001). PET/CT [18F]F-Choline was able to detect local disease, not previously known from MRI, in 29.41% of patients. PET/CT Choline had an impact on therapeutic management in 67 of 108 patients (62%).
Conclusions:
PET/CT with [18F]F-Fluoromethylcholine is a useful tool in the detection of locoregional and disseminated disease of PC treated with suspicion of recurrence, providing a change in therapeutic management in 62% of patients.
Keywords:
Biochemical recurrence; Cáncer de próstata; PET/CT [(18)F]F-Choline; PET/TC [(18)F]F-Colina; Prostate cancer; Recidiva bioquímica.
Copyright © 2020 Sociedad Española de Medicina Nuclear e Imagen Molecular. Publicado por Elsevier España, S.L.U. All rights reserved.
MeSH terms
-
Adenocarcinoma / blood
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Adenocarcinoma / diagnostic imaging
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Adenocarcinoma / secondary*
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Adenocarcinoma / therapy
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Aged
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Aged, 80 and over
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Bone Neoplasms / diagnostic imaging
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Bone Neoplasms / secondary*
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Choline / analogs & derivatives*
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Disease Management
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Fluorine Radioisotopes*
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Humans
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Incidental Findings
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Kallikreins / blood*
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Lung Neoplasms / diagnostic imaging
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Lung Neoplasms / secondary*
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Lymphatic Metastasis / diagnostic imaging
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Neoplasm Recurrence, Local / diagnostic imaging*
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Neoplasms, Second Primary / diagnostic imaging
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Positron Emission Tomography Computed Tomography*
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Prospective Studies
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Prostate-Specific Antigen / blood*
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Prostatic Neoplasms / blood
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Prostatic Neoplasms / diagnostic imaging*
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Prostatic Neoplasms / therapy
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Radiopharmaceuticals*
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Sensitivity and Specificity
Substances
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Fluorine Radioisotopes
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Radiopharmaceuticals
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fluoromethylcholine
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fluorocholine
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KLK3 protein, human
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Kallikreins
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Prostate-Specific Antigen
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Fluorine-18
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Choline