Article Figures & Data
Figures
- FIGURE 1.
66-y-old patient with Gleason score of 4 + 4 and pT3aN0(0/12)Mx cancer. Initial PSA was 8 ng/mL. Patient was treated with RP. BCR (PSA, 0.4 ng/mL; PSA doubling time, 6 mo) occurred 12 mo after RP. (A) 11C-choline PET/CT (maximum-intensity-projection [MIP], CT, and fused images) showed single left common iliac lymph node (SUVmax, 4; diameter, 8 mm). Metastasis-directed S-RT was subsequently performed; PSA nadir was 0.08 ng/mL. (B) 11C-choline PET/CT performed 3 mo after S-RT (MIP, CT, and fused images) showed complete metabolic response.
- FIGURE 2.
70-y-old patient with Gleason score of 4 + 4 and pT3aN1(2/15)Mx cancer. Initial PSA was 21 ng/mL. Patient was treated with RP. BCR (PSA, 11 ng/mL; PSA doubling time, 4.1 mo) occurred 10 mo after external-beam radiotherapy (EBRT). (A) 11C-choline PET/CT (maximum-intensity-projection [MIP] and fused images) showed single osteoblastic lesion involving right ilium and pubis bones (SUVmax, 10). (B) Patient was referred for metastasis-directed EBRT; PSA response (PSA, 0.4 ng/mL) after treatment was confirmed by 11C-choline PET/CT performed 3 mo after EBRT (MIP and fused images).
- FIGURE 3.
62-y-old patient with Gleason score of 4 + 4 and pT3b N1(8/24)Mx cancer. Initial PSA was 18 ng/mL. Patient was treated with RP. BCR occurred 8 mo after RP, and ADT was administered. After 26 mo, patient developed CRPC (PSA, 14 ng/mL; PSA doubling time, 3.2 mo). (A) 11C-choline PET/CT (maximum-intensity-projection [MIP] images) showed positive lymph nodes in paratracheal region and left supraclavicular lymph node, and docetaxel was administered. (B) Subsequent 11C-choline PET/CT (MIP images) showed progression of disease (in mediastinal lymph nodes and third left rib) despite PSA response (PSA, 10 ng/mL). Patient was given abiraterone; PSA response occurred after 6 mo (PSA, 4 ng/mL). (C) 11C-choline PET/CT (MIP images) showed response of mediastinal lymph nodes and rib but increased uptake in supraclavicular lymph node. (D) Patient was given metastasis-directed external-beam radiotherapy; PSA response (PSA, 1 ng/mL) and partial response on 11C-choline PET/CT (MIP images) occurred.
- FIGURE 4.
Additional images of same patient as in Figure 3. (A) Fused images of left supraclavicular lymph node before metastasis-directed external-beam radiotherapy (EBRT). (B) Fused images of left supraclavicular lymph node after metastasis-directed EBRT. 11C-choline uptake decreased after EBRT, but necrotic component of node enlarged after EBRT (arrows).
