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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 1/2012

01-01-2012 | Original Article

[11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: comparison with bone scintigraphy

Authors: Maria Picchio, Elena Giulia Spinapolice, Federico Fallanca, Cinzia Crivellaro, Giampiero Giovacchini, Luigi Gianolli, Cristina Messa

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2012

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Abstract

Purpose

The aim of this study was to evaluate the clinical usefulness of [11C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa).

Methods

Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2–500.0 ng/ml) referred for both [11C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [11C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive anti-androgenic treatment.

Results

Equivocal findings occurred in 1 of 78 (1%) cases in [11C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [11C]choline PET/CT were 89–89%, 98–100%, 96–100%, 94–96% and 95–96%, respectively. For BS they were 100–70%, 75–100%, 68-–100%, 100–86% and 83–90%, respectively. Concordant findings between [11C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [11C]choline PET/CT did not significantly (p = 0.30) differ between hormone-resistant patients (97%) and those who did not receive anti-androgenic treatment (95%).

Conclusion

In clinical practice, [11C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [11C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [11C]choline PET/CT.
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Metadata
Title
[11C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: comparison with bone scintigraphy
Authors
Maria Picchio
Elena Giulia Spinapolice
Federico Fallanca
Cinzia Crivellaro
Giampiero Giovacchini
Luigi Gianolli
Cristina Messa
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2012
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-011-1920-z

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