Skip to main content
SpringerLink
Log in

Changes in Skeletal Tumor Activity on 18F-choline PET/CT in Patients Receiving 223Radium Radionuclide Therapy for Metastatic Prostate Cancer

  • Case Report
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

An Erratum to this article was published on 16 October 2015

Abstract

Radium-223 dichloride is an alpha-emitting radiopharmaceutical shown to prolong survival in patients with castrate-resistant prostate cancer (CRPC) and symptomatic skeletal metastases. This report describes in two patients the acute changes in bone metastatic activity detected by F-18 choline PET/CT imaging midway during treatment with radium-223 dichloride. In addition to visual and standardized uptake value analysis, changes in the whole-body tumor burden were quantified by measuring the difference in net metabolically active tumor volume (MATV) and total lesion activity (TLA) between pre- and mid-treatment PET scans. After the third dose of radium-223 dichloride, near-total disappearance of abnormal skeletal activity was observed in one case (net MATV change from 260.7 to 0.8 cc; net TLA change from 510.7 to 2.1), while a heterogeneous tumor response was observed in the other (net MATV change from 272.2 to 241.3 cc; net TLA change from 987.1 to 779.4). Corresponding normalization and persistent elevation in serum alkaline phosphatase levels were observed in these cases, respectively. Further research is needed to determine the predictive value of serial F-18 choline PET/CT imaging in patients receiving radium-223 dichloride for CRPC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fossa SD, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013;369(3):213–23.

    Article  CAS  PubMed  Google Scholar 

  2. Schoder H, Herrmann K, Gonen M, Hricak H, Eberhard S, Scardino P, et al. 2-[18 F]fluoro-2-deoxyglucose positron emission tomography for the detection of disease in patients with prostate-specific antigen relapse after radical prostatectomy. Clin Cancer Res: Off J Am Assoc Cancer Res. 2005;11(13):4761–9.

    Article  Google Scholar 

  3. Glunde K, Jacobs MA, Bhujwalla ZM. Choline metabolism in cancer: implications for diagnosis and therapy. Expert Rev Mol Diagn. 2006;6(6):821–9.

    Article  CAS  PubMed  Google Scholar 

  4. 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(1):273–80.

    Article  PubMed  Google Scholar 

  5. Kwee SA, Lim J, Watanabe A, Kromer-Baker K, Coel MN. Prognosis related to metastatic burden measured by 18 F-fluorocholine PET/CT in castration-resistant prostate cancer. J Nucl Med: Off Publ Soc Nucl Med. 2014;55(6):905–10.

    Article  CAS  Google Scholar 

  6. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.

    Article  CAS  PubMed  Google Scholar 

  7. Sonpavde G, Pond GR, Berry WR, de Wit R, Armstrong AJ, Eisenberger MA, et al. Serum alkaline phosphatase changes predict survival independent of PSA changes in men with castration-resistant prostate cancer and bone metastasis receiving chemotherapy. Urol Oncol. 2012;30(5):607–13.

    Article  CAS  PubMed  Google Scholar 

  8. Balogova S, Huchet V, Egrot C, Michaud L, Paycha F, Kerrou K, et al. Effect of erythropoietin on bone marrow uptake of 18 F-fluorocholine in prostate cancer: comparison with 18 F-fluoride uptake. Clin Nucl Med. 2013;38(3):200–2.

    Article  PubMed  Google Scholar 

Download references

Disclosure

Kyle S. Miyazaki, Yu Kuang, and Sandi A. Kwee declare that they have no conflicts of interest. All study procedures were in accordance with an institutional review board-approved human subject research protocol that complies with the ethical standards set forth in the 1964 Declaration of Helsinki and all subsequent amendments thereof. Written informed consent and authorization for the use and reporting of de-identified clinical information were obtained from the patients included in this study.

Author information

Authors and Affiliations

  1. Oncology Research Department and Hamamatsu/Queen’s PET Imaging Center, The Queen’s Medical Center, 1301 Punchbowl St., Honolulu, HI, 96813, USA

    Kyle S. Miyazaki & Sandi A. Kwee

  2. Department of Medical Physics, School of Allied Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA

    Yu Kuang

  3. University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA

    Sandi A. Kwee

Authors
  1. Kyle S. Miyazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yu Kuang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sandi A. Kwee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandi A. Kwee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyazaki, K.S., Kuang, Y. & Kwee, S.A. Changes in Skeletal Tumor Activity on 18F-choline PET/CT in Patients Receiving 223Radium Radionuclide Therapy for Metastatic Prostate Cancer. Nucl Med Mol Imaging 49, 160–164 (2015). https://doi.org/10.1007/s13139-014-0314-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-014-0314-0

Keywords

Search

Navigation