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Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer

Husarik, Daniela ; Miralbell, Raymond ; Dubs, Markus ; John, Hubert ; Giger, Olivier ; Gelet, Albert ; Cservenyàk, Tibor ; Hany, Thomas

In: European Journal of Nuclear Medicine and Molecular Imaging, 2008, vol. 35, no. 2, p. 253-263

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    Title
    • Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer
    Author
    • Husarik, Daniela. Department of Nuclear Medicine, University Hospital of Zurich, C NUK 8a, Raemistrasse 100, 8091, Zürich, Switzerland
    • Miralbell, Raymond. Department of Radiation Oncology, University Hospital Geneva, Geneva, Switzerland
    • Dubs, Markus. Department of Urology, Hospital of Uster, Uster, Switzerland
    • John, Hubert. Department of Urology, Klinik Hirslanden, Zurich, Switzerland
    • Giger, Olivier. Department of Pathology, University Hospital Zurich, Zurich, Switzerland
    • Gelet, Albert. Department of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France
    • Cservenyàk, Tibor. Department of Nuclear Medicine, University Hospital of Zurich, C NUK 8a, Raemistrasse 100, 8091, Zürich, Switzerland
    • Hany, Thomas. Department of Nuclear Medicine, University Hospital of Zurich, C NUK 8a, Raemistrasse 100, 8091, Zürich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • European Journal of Nuclear Medicine and Molecular Imaging, 2008, vol. 35, no. 2, p. 253-263. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:321430
    Summary
    Purpose: To evaluate the accuracy of [18F]-choline (FCH) positron emission tomography/computed tomography (PET/CT) for staging and restaging of prostate cancer. Methods: FCH PET/CT was performed in 111 patients with prostate cancer using 200MBq FCH: 43 patients [mean age 63years; mean prostrate specific antigen (PSA) 11.58μg/l] were examined for initial staging, and 68 patients (mean age 66.4years) were examined for restaging (mean PSA 10.81μg/l). FCH PET/CT results were correlated to histopathology, bone scan, morphology as revealed by magnetic resonance imaging (MRI) and CT, PET/CT follow-up and PSA follow-up after therapy. Results: FCH PET/CT scans at initial staging correctly showed no metastases in 36/38 patients undergoing radical surgery, as confirmed by PSA levels <0.1μg/l 6months postoperatively. Lymphadenectomy was performed in 24 of these patients, revealing four false FCH-negative lymph nodes (LN). In one patient, only lymphadenectomy was performed since a FCH-positive LN was confirmed by histology. Four patients showed FCH-positive bone metastases, as proven by bone scan. FCH PET/CT scans at restaging correctly revealed local recurrence in 36 patients. No pathological FCH uptake was observed in 11 patients with biochemical recurrence. Twenty-three patients showed FCH-positive LN. Twenty LN were surgically removed in seven patients. Histopathology verified metastases in all LN, but revealed two additional metastastic, FCH-negative LN. Seventeen patients showed FCH-positive bone metastases, as proven by bone scan or MRI. Sensitivity to detect recurrent disease was 86%. Conclusion: The results obtained using FCH PET/CT scans for initial N-staging were discouraging, especially in terms of its inability to detect small metastases. Recurrent disease can be localized reliably in patients with PSA levels of >2μg/l