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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Effectiveness of 11C-choline PET/CT in prostate cancer surveillance
Journal Information
Vol. 42. Issue 2.
Pages 93-99 (March - April 2023)
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Vol. 42. Issue 2.
Pages 93-99 (March - April 2023)
Original Article
Effectiveness of 11C-choline PET/CT in prostate cancer surveillance
Rendimiento de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata
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I. Martínez-Rodríguez
Corresponding author
misabel.martinez@scsalud.es

Corresponding author.
, M. de Arcocha-Torres, F.J. Gómez-de la Fuente, J. Jiménez-Bonilla, A. Sánchez-Salmón, N. Martínez-Amador, V. Mendi-Barcina, J. Andrés-Pacheco, A. Gutiérrez-González, M. Pombo-López, A. Bota-Bota, M. Rodil-Gallego, A. García-Ruiz, R. Quirce
Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Grupo de Imagen Molecular, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Cantabria, Spain
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Tables (5)
Table 1. Characteristics of the patients included in the study.
Table 2. Localization of the [11C]-choline PET/CT findings in the 219 positive studies and in the 23 studies with serum PSA levels < 1 ng/mL.
Table 3. Global results with [11C]-choline PET/CT and posterior therapeutic management according to the type of initial treatment and serum PSA level.
Table 4. Global results of [11C]-choline PET/CT and posterior therapeutic management according to the reason for the study and serum PSA level.
Table 5. Clinical evolution of the 63 patients with serum PSA levels < 1 ng/mL (considering only the last PET/CT performed in patients with more than 1 study), grouped according to the initial treatment and the reasons for performing [11C]-choline PET/CT.
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Abstract
Aim

Our aim was to analyse the performance of [11C]choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/mL.

Material and methods

Three hundred and twenty-nine [11C]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 [11C]choline. Minimum follow-up was 12 months.

Results

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 [11C]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.

Conclusion

[11C]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.

Keywords:
11C-choline
PET/CT
Prostate cancer
Prostate specific antigen
Biochemical recurrence
Resumen
Objetivo

Analizar el rendimiento diagnóstico de la PET/TC con [11C]colina en el seguimiento del cáncer de próstata (CaP), especialmente en pacientes con antígeno prostático específico (PSA) < 1 ng/mL.

Material y métodos

Se evaluaron retrospectivamente 329 exploraciones PET/TC con [11C]colina de 191 pacientes (68,2 ± 7,2 años) con CaP con recaída bioquímica o en seguimiento (PSA al momento del PET/TC: 13,0 ± 84,2 ng/mL). El tratamiento inicial fue prostatectomía radical (PR) en 81 pacientes y otros tratamientos (radioterapia, quimioterapia, hormonoterapia) en 110. La PET/TC se adquirió 20' después de la inyección de 555-740 MBq de [11C]colina. El seguimiento mínimo fue superior a 12 meses.

Resultados

Doscientos diecinueve (66,6%) de las 329 exploraciones PET/TC fueron positivas. El porcentaje de positivos fue significativamente mayor en los pacientes con otro tratamiento inicial diferente a la PR (85,6% frente a 43,6%, respectivamente). Ciento treinta PET/TC (59,4%) mostraron recidiva local, 48 (21,9%) a distancia y 41 (18,7%) local más a distancia. El abordaje terapéutico inicial se modificó en 139 casos (63,5%). De los 81 PET/TC con [11C]colina realizados con PSA < 1 ng/mL, 23 (28,4%) fueron positivos. El abordaje terapéutico inicial se modificó en 9 (11,1%). Tres de 63 pacientes (4,8%) fallecieron por CaP.

Conclusiones

La PET/TC con [11C]colina demostró su eficacia en el seguimiento y la reestadificación del CaP, incluso en pacientes con PSA sérico < 1 ng/mL. El rendimiento diagnóstico fue diferente según el tratamiento inicial al que fueron sometidos los pacientes, siendo mayor en aquellos tratados inicialmente con otros tratamientos distintos de la PR.

Palabras clave:
11C-colina
PET/TC
Cáncer de próstata
Antígeno prostático específico
Recaída bioquímica

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