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Inicio Medicina Clínica (English Edition) Usefulness of 18F-fluorocoline PET/CT in prostate cancer patients with biochemic...
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Vol. 153. Issue 2.
Pages 56-62 (July 2019)
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Vol. 153. Issue 2.
Pages 56-62 (July 2019)
Original article
Usefulness of 18F-fluorocoline PET/CT in prostate cancer patients with biochemical recurrence: Influence of PSA kinetics and hormone therapy
Utilidad de la PET/TC con 18F-fluorocolina en la recidiva bioquímica del cáncer de próstata: relevancia de la cinética del PSA y la terapia hormonal
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Eva María Triviño-Ibáñeza,c, Ignacio Puche-Sanzb,c, Manuel Gómez-Ríoa,c, José Manuel Cózar Olmob,c, José Manuel Llamas-Elviraa,c, Antonio Rodríguez-Fernándeza,c,
Corresponding author
a UGC Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
b UGC Urología, Hospital Universitario Virgen de las Nieves, Granada, Spain
c IBS Granada, Instituto de Investigación Biosanitaria de Granada, Granada, Spain
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Tables (3)
Table 1. Baseline characteristics of the study population.
Table 2. Comparative analysis of FCH PET/CT positive vs. negative.
Table 3. Multivariate logistic regression of the predictive factors of a FCH PET/CT positive result.
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Abstract
Purpose

To evaluate the capacity of 18F-fluorocholine positron emission tomography/computed tomography (FCH PET/CT) to detect biochemical recurrence of prostate cancer and to determine the correlation with PSA kinetics and influence of antiandrogen hormone therapy.

Patients and methods

Observational and retrospective study, which included patients with prostate cancer and criteria for biochemical recurrence and/or resistance to castration, according to the European Association of Urology. FCH PET/CT results were classified as positive or negative, using as gold standard the pathology report, findings of other imaging test, and/or clinical follow-up results. The correlation between FCH PET/CT and PSA kinetics (PSA at the time of exploration [PSA-trigger], doubling time [PSAdt] and velocity [PSAva]) was studied and the influence of hormone therapy was analysed.

Results

The study included 203 patients. The FCH PET/CT detection rate was 43.3%. The group of patients with FCH PET/CT positive showed more aggressive PSA kinetics (PSAdt: 7.5 months and PSAva 8.37±14.8ng/ml/year) than the FCH PET/CT negative group (PSAdt: 14.5±7.6 months and PSAva: 1.8±3.7ng/ml/year). The detection rate of FCH PET/CT in the subgroup with castration resistance was 89.1%, significantly higher than in the group with radical treatment at 29.9%, p<0.001.

Conclusions

FCH PET/CT is useful to detect biochemical recurrence of prostate cancer, especially in patients who receive hormone therapy or more aggressive PSA kinetics.

Keywords:
PET/CT
18F-fluorocholine
Prostate cancer
Biochemical recurrence prostate
Antiandrogenic therapy
PSA kinetics
Resumen
Objetivo

Evaluar la capacidad de la 18F-fluorometilcolina (FCH) tomografía por emisión de positrones/tomografía computarizada (PET/TC) en la detección de la enfermedad en la recidiva bioquímica del cáncer de próstata, su correlación con la cinética del antígeno prostático específico (PSA) y la influencia de la terapia hormonal antiandrogénica.

Pacientes y métodos

Estudio observacional y retrospectivo, que incluyó a pacientes con cáncer de próstata y criterios de recidiva bioquímica y/o resistencia a la castración, según la Asociación Europea de Urología. Los resultados de la FCH PET/TC se categorizaron en dos grupos (positivo vs. negativo) utilizando como gold estándar la anatomía patológica, otras pruebas de imagen y/o seguimiento clínico. Se estudió la relación entre la FCH PET/TC y la cinética del PSA (PSA en el momento de la exploración [trigger-PSA], tiempo de duplicación [PSAdt] y velocidad de ascenso [PSAva]) y se analizó la influencia de la terapia hormonal.

Resultados

Se incluyeron 203 pacientes. La tasa de detección global de la FCH PET/TC fue del 43,3%. El grupo de pacientes con FCH PET/TC positiva mostró una cinética de PSA más agresiva (PSAdt: 7,5±7,5meses y PSAva 8,37±14,8ng/ml/a) que el grupo FCH PET/TC negativa (PSAdt: 14,5±7,6meses y PSAva: 1,8±3,7ng/ml/a). La tasa de detección de la FCH-PET/TC en el subgrupo con resistencia a la castración fue del 89,1%, significativamente mayor a la tasa del 29,9% del grupo con tratamiento curativo, p<0,001.

Conclusiones

La FCH PET/TC es útil en la detección de la enfermedad en la recidiva bioquímica del cáncer de próstata, especialmente en los pacientes con terapia hormonal o cinética del PSA más agresiva.

Palabras clave:
PET/TC
18F-fluorocolina
Cáncer de próstata
Recidiva bioquímica
Terapia hormonal
Cinética PSA

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