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[11C]Choline uptake with PET/CT for the initial diagnosis of prostate cancer: relation to PSA levels, tumour stage and anti-androgenic therapy

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Abstract

Purpose

The accuracy of positron emission tomography (PET)/CT with [11C]choline for the detection of prostate cancer is not well established. We assessed the dependence of [11C]choline maximum standardized uptake values (SUVmax) in the prostate gland on cell malignancy, prostate-specific antigen (PSA) levels, Gleason score, tumour stage and anti-androgenic hormonal therapy.

Methods

In this prospective study, PET/CT with [11C]choline was performed in 19 prostate cancer patients who subsequently underwent prostatectomy with histologic sextant analysis (group A) and in six prostate cancer patients before and after anti-androgenic hormonal therapy (bicalutamide 150 mg/day; median treatment of 4 months; group B).

Results

In group A, based on a sextant analysis with a [11C]choline SUVmax cutoff of 2.5 (as derived from a receiver-operating characteristic analysis), PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 72, 43, 64, 51 and 60%, respectively. In the patient-by-patient analysis, no significant correlation was detected between SUVmax and PSA levels, Gleason score or pathological stage. On the contrary, a significant (P < 0.05) negative correlation was detected between SUVmax and anti-androgenic therapy both in univariate (r 2 = 0.24) and multivariate (r 2 = 0.48) analyses. Prostate [11C]choline uptake after bicalutamide therapy significantly (P < 0.05) decreased compared to baseline (6.4 ± 4.6 and 11.8 ± 5.3, respectively; group B).

Conclusion

PET/CT with [11C]choline is not suitable for the initial diagnosis and local staging of prostate cancer. PET/CT with [11C]choline could be used to monitor the response to anti-androgenic therapy.

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Authors and Affiliations

  1. Center for Molecular Bioimaging, University of Milano-Bicocca, Milan, Italy

    Giampiero Giovacchini, Elisa Coradeschi, Ferruccio Fazio & Cristina Messa

  2. Department of Nuclear Medicine, Scientific Institute San Raffaele, Milan, Italy

    Maria Picchio, Valentino Bettinardi & Ferruccio Fazio

  3. Department of Urology, Scientific Institute San Raffaele, Milan, Italy

    Vincenzo Scattoni

  4. Department of Radiation Oncology, Scientific Institute San Raffaele, Milan, Italy

    Cesare Cozzarini & Ferruccio Fazio

  5. Department of Pathology, Scientific Institute San Raffaele, Milan, Italy

    Massimo Freschi

  6. Institute for Bioimaging and Molecular Physiology, National Research Council, Milan, Italy

    Ferruccio Fazio & Cristina Messa

  7. Department Nuclear Medicine, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy

    Cristina Messa

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  1. Giampiero Giovacchini
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Correspondence to Cristina Messa.

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Giovacchini, G., Picchio, M., Coradeschi, E. et al. [11C]Choline uptake with PET/CT for the initial diagnosis of prostate cancer: relation to PSA levels, tumour stage and anti-androgenic therapy. Eur J Nucl Med Mol Imaging 35, 1065–1073 (2008). https://doi.org/10.1007/s00259-008-0716-2

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  • DOI: https://doi.org/10.1007/s00259-008-0716-2

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