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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2008

01-02-2008 | Original Article

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

Authors: Daniela B. Husarik, Raymond Miralbell, Markus Dubs, Hubert John, Olivier T. Giger, Albert Gelet, Tibor Cservenyàk, Thomas F. Hany

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2008

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Abstract

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 200 MBq FCH: 43 patients [mean age 63 years; mean prostrate specific antigen (PSA) 11.58 μg/l] were examined for initial staging, and 68 patients (mean age 66.4 years) were examined for restaging (mean PSA 10.81 μg/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 <0.1 μg/l 6 months 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 >2 μg/l.
Literature
1.
Jemal A, Murray T, Ward E, Murray T, Xu J, Smigal C, Thun MJ. Cancer statistics 2005. CA Cancer J Clin 2005; 55:10–30.
2.
Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H. EAU guidelines on prostate cancer. Eur Urol 2005; 48:546–51.
3.
Gambhir SS, Czernin J, Schwimmer J, Silverman DH, Coleman RE, Phelps ME. A tabulated summary of the FDG PET literature. J Nucl Med 2001; 42:1S–93S.PubMed
4.
Hautzel H, Muller-Mattheis V, Herzog H, Roden W, Coenen HH,. Ackermann R, et al. The (11C) acetate positron emission tomography in prostatic carcinoma. New prospects in metabolic imaging. Urologe A 2002; 41:569–76.
5.
de Jong IJ, Pruim J, Elsinga PH, Jongen MM, Mensink HJ, Vaalburg W. Visualisation of bladder cancer using (11)C-choline PET: first clinical experience. Eur J Nucl Med Mol Imaging 2002; 29:1283–8.PubMedCrossRef
6.
Hara T, Kosaka N, Kishi H. Development of (18)F-fluoroethylcholine for cancer imaging with PET: synthesis, biochemistry, and prostate cancer imaging. J Nucl Med 2002; 43:187–99.PubMed
7.
DeGrado TR, Coleman RE, Wang S, Baldwin SW, Orr MD, Robertson CN, Polascik TJ, Price DT. Synthesis and evaluation of 18F-labeled choline as an oncologic tracer for positron emission tomography: initial findings in prostate cancer. Cancer Res 2001; 61:110–7.
8.
Kotzerke J, Prang J, Neumaier B, Volkmer B, Guhlmann A, Kleinschmidt K, et al. Experience with carbon-11 choline positron emission tomography in prostate carcinoma. Eur J Nucl Med 2000; 27:1415–9.
9.
Hara T, Kosaka N, Kishi H. PET imaging of prostate cancer using carbon-11-choline. J Nucl Med 1998; 39:990–5.PubMed
10.
Cimitan M, Bortolus R, Morassut S, Canzonieri V, Garbeglio A, Baresic T, Borsatti E, Drigo A, Trovo MG. [18]F-fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging 2006; 33:1387–1398.
11.
Schmid DT, John H, Zweifel R, Cservenyak T, Wetsera G, Goerres GW, et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005; 235:623–8.
12.
Martorana G, Schiavina R, Corti B, Farsad M, Salizzoni E, Brunocilla E, et al. [11]C-choline positron emission tomography/computerized tomography for tumor localization of primary prostate cancer in comparison with 12-core biopsy. J Urol 2006; 176:954–60.
13.
Reske SN, Blumstein NM, Neumaier B, Gottfried HW. et al. Imaging prostate cancer with 11C-Choline PET/CT. J Nucl Med 2006; 47:1249–54.
14.
Pagliarulo V, Hawes D, Brands FH, Groshen S, Cai J, Stein P, Lieskovsky G, Skinner DG, Coteet RJ. Detection of occult lymph node metastases in locally advanced node-negative prostate cancer. J Clin Oncol 2006; 24:2735–42.
15.
Joslyn SA, Konety BR. Impact of extent of lymphadenectomy on survival after radical prostatectomy for prostate cancer. Urology 2006; 68:121–5.PubMedCrossRef
16.
Schumacher MC, Burkhard FC, Thalmann GN, Fleischmann A, Studer UE. Is pelvic lymph node dissection necessary in patients with a serum PSA<10 ng/ml undergoing radical prostatectomy for prostate cancer? Eur Urol 2006; 50:272–9.PubMedCrossRef
17.
Weckermann D, Goppelt M, Dorn R, Wawroschek F, Harzmann R. Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate-specific antigen (PSA) level of ≤10 ng/mL and biopsy Gleason score of ≤6, and their influence on PSA progression-free survival after radical prostatectomy. BJU Int 2006; 97:1173–8.PubMedCrossRef
18.
Langsteger W, Heinisch M, Fogelman I. The role of fluorodeoxyglucose, 18F-dihydroxyphenylalanine, 18F-choline, and 18F-fluoride in bone imaging with emphasis on prostate and breast. Semin Nucl Med 2006; 36:73–92.PubMedCrossRef
19.
Freedland SJ, Sutter ME, Dorey F, Aronson WJ. Defining the ideal cutpoint for determining PSA recurrence after radical prostatectomy. Prostate-specific antigen. Urology 2003; 61:365–9.PubMedCrossRef
20.
Harisinghani MG, Barentsz J, Hahn PF, Deserno WM, Tabatabaei S, et al. Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N Engl J Med 2003; 348:2491–9.
21.
Cornud F, Bellin MF, Portalez D. MRI and staging evaluation of prostate cancer. J Radiol 2006; 87:228–43.PubMed
22.
Sella T, Schwartz LH, Swindle PW, Onyebuchi CN, Scardino PT, Scher HI, Hricak H. Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 2004; 231:379–85.
23.
Heinisch M, Dirisamer A, Loidl W, Stoiber F, Gruy B, Haim S, Langsteger W. Positron emission tomography/computed tomography with F-18-fluorocholine for restaging of prostate cancer patients: meaningful at PSA < 5 ng/ml? Mol Imaging Biol 2006; 8:43–8.
24.
Price DT, Coleman RE, Liao RP, Robertson CN, Polascik TJ, DeGrado TR. Comparison of [18 F]fluorocholine and [18 F]fluorodeoxyglucose for positron emission tomography of androgen dependent and androgen independent prostate cancer. J Urol 2002; 168:273–80.PubMedCrossRef
25.
Poissonnier L, Chapelon JY, Rouviere O, et al. Control of prostate cancer by transrectal HIFU in 227 patients. Eur Urol 2006; 51:381–387.
26.
Hacker A, Jeschke S, Leeb K, Prammer K, Ziegerhofer J, Sega W, et al. Detection of pelvic lymph node metastases in patients with clinically localized prostate cancer: comparison of [18F]fluorocholine positron emission tomography-computerized tomography and laparoscopic radioisotope guided sentinel lymph node dissection. J Urol 2006; 176:2014–18; discussion 2018–19.
Metadata
Title
Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer
Authors
Daniela B. Husarik
Raymond Miralbell
Markus Dubs
Hubert John
Olivier T. Giger
Albert Gelet
Tibor Cservenyàk
Thomas F. Hany
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0552-9

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