11C-CHOLINE PET/CT IN RECURRENCE DETECTION IN SURGICALLY TREATED PROSTATE CANCER PATIENTS WITH LOW PSA LEVEL

¹¹C-CHOLINE PET/CT IN RECURRENCE DETECTION IN SURGICALLY TREATED PROSTATE CANCER PATIENTS WITH LOW PSA LEVEL

Aslanidis I.P.¹, Pursanova D.M.¹, Mukhortova O.V.¹, Katunina T.A.¹, Shirokorad V.I.², Roshchin D.A.³

Purpose. To evaluate the usefulness of ¹¹C-Choline PET/CT in patients after radical prostatectomy with low PSA level for detection of PCa relapse.

1 - Bakoulev Scientific Center for
Cardiovascular Surgery.
2 - Moscow City
Oncology Hospital № 62.
3 - N. Lopatkin Scientific Research Institute of Urology and
Interventional Radiology.
Moscow, Russia.

Materials and methods. PET/CT was performed in 63 patients on PET/CT scanner (Biograph-64, Siemens) 10 min after injection of ¹¹C-Choline (700–950 Mbq). The mean PSA value in the group was 0.94±0.51 (0.21–1.98) ng/ml, median – 0.93 ng/ml.

Results. Overall, ¹¹C-Choline PET/CT detected PCa relapse in 30% (19/63) of cases. There was no statistical difference between PET-positive (n=19) and PET-negative (n=44) patients according to age, time to biochemical relapse after surgery, Gleason score and ongoing hormone therapy.

The detection rate of relapse according to ¹¹C-Choline PET/CT showed correlation (p=0,007) with serum PSA: positive PET/CT results were obtained in 30% (19/63) patients with PSA<2,0 ng/ml, in 23% (12/53) – with PSA<1,5 ng/ml, in 17% (6/36) – with PSA<1,0 ng/ml, and in 20% (3/15) – with PSA<0,5 ng/ml.

PSA doubling time <6 months, stage >T3 and N1 were significantly associated with an increased probability of positive PET/CT findings (р<0,05 for all). All these parameters were found to be independent predictive factors for PET-positive result at simple linear regression analysis. The combination of mentioned predictors, except N1, was statistically significant in the prediction of a positive PET/CT at multiple linear regression analysis.

Local relapse was detected in 63% (12/19) patients, distant metastases – in 11% (2/19) cases, and both local and distant metastases – in 11% (2/19) cases.

Conclusions. ¹¹C-Choline PET/CT was able to detect and correctly identify the localization of PCa relapse (local and distant) in 30% of patients with PSA<2,0 ng/ml, and therefore was useful in selection of further therapeutic approach. Pathological stage (>T3, N1), trigger PSA and short PSA doubling time were found to be significant predictors for PET-positive result and should be considered in patient selection for ¹¹C-Choline PET/CT.

Keywords: prostate cancer recurrence, PET/CT, ¹¹C-Choline, PSA, biochemical recurrence, choline.

Corresponding author: Pursanova D.M., Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Aslanidis I.P., Pursanova D.M., Mukhortova O.V., Katunina T.A., Shirokorad V.I., Roshchin D.A.¹¹c-choline pet/ct in recurrence detection in surgically treated prostate cancer patiens with low psa level REJR. 2016; 6 (2):60-71. DOI:10.21569/2222-7415-2016-6-2-60-71.

Received: 23.03.2016 Accepted: 04.04.2016