Dual Tracer 11C-Choline and FDG-PET in the Diagnosis of Biochemical Prostate Cancer Relapse After Radical Treatment
José A. Richter (1), Macarena Rodríguez (1), Jorge Rioja (2), Iván Peñuelas (1), Josep Martí-Climent (1), Puy Garrastachu (1), Gemma Quincoces (1), María J. García-Velloso (1).
(1) Nuclear Medicine Department, Clínica Universitaria, Universidad de Navarra, Avda, Pío XII 36, 31008, Pamplona, Spain
(2) Urology Department, Clínica Universitaria, Universidad de Navarra, Avda, Pío XII 36, 31008, Pamplona, Spain
The purpose of this study was to evaluate a dual tracer 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) and (11)C-choline positron emission tomography (PET) protocol in the detection of biochemical prostate cancer relapse.
Seventy-three patients (median Prostate Specific Antigen (PSA) Test value 2.7 ng/ml (1.1-5.4)) after radical treatment. PET scans were performed by means of a ECAT-Exact HR+ in the first 18 patients and in a PET/computed tomography Biograph II in the remaining 55 patients.
The sensitivity of (11)C-choline and FDG was 60.6% and 31%. In PSA levels over 1.9 ng/ml, sensitivity increased to 80% and 40%, respectively. In the group receiving adjuvant hormone therapy, the diagnostic yields were 71.2% and 43%, respectively. While (11)C-choline-PET could not differentiate well and poorly differentiated Gleason score patients, FDG-PET results were almost significant (p = 0.058).
A PSA value higher than 1.9 ng/ml determines a significant increase in the diagnostic yield. Adjuvant hormonotherapy has no influence on the PET results. FDG has a better correlation with the Gleason score than (11)C-choline.
CITATION Mol Imaging Biol. 2010 Apr;12(2):210-7