[11C]Choline positron emission tomography/computed tomography for staging and restaging of patients with advanced prostate cancer

Tuncel, Murat; Souvatzoglou, Michael; Herrmann, Ken; Stollfuss, Jens; Schuster, Tibor; Weirich, Gregor; Wester, Hans-Jürgen; Schwaiger, Markus; Krause, Bernd J.

doi:10.1016/j.nucmedbio.2008.05.006

« Previous Next »Nuclear Medicine and Biology
Volume 35, Issue 6 , Pages 689-695, August 2008

[¹¹C]Choline positron emission tomography/computed tomography for staging and restaging of patients with advanced prostate cancer

Murat Tuncel
- Department of Nuclear Medicine, Klinikum rechts der lsar, Technische Universität München, 81675 Munich, Germany
Michael Souvatzoglou
- Department of Nuclear Medicine, Klinikum rechts der lsar, Technische Universität München, 81675 Munich, Germany
Ken Herrmann
- Department of Nuclear Medicine, Klinikum rechts der lsar, Technische Universität München, 81675 Munich, Germany
Jens Stollfuss
- Department of Radiology, Technische Universität München, 81675 Munich, Germany
Tibor Schuster
- Department of Statistics, Technische Universität München, 81675 Munich, Germany
Gregor Weirich
- Department of Pathology, Technische Universität München, 81675 Munich, Germany
Hans-Jürgen Wester
- Department of Nuclear Medicine, Klinikum rechts der lsar, Technische Universität München, 81675 Munich, Germany
Markus Schwaiger
- Department of Nuclear Medicine, Klinikum rechts der lsar, Technische Universität München, 81675 Munich, Germany
Bernd J. Krause
- Department of Nuclear Medicine, Klinikum rechts der lsar, Technische Universität München, 81675 Munich, Germany
- Corresponding author. Tel.: +49 89 4140 2961; fax: +49 89 4140 4950.

Received 1 April 2008; received in revised form 6 May 2008; accepted 21 May 2008.

Abstract

Introduction

To evaluate [¹¹C]Choline positron emission tomography (PET)/computed tomography (CT) for staging and restaging of patients with advanced prostate cancer and to compare the diagnostic performance of PET, CT and PET/CT.

Methods

Forty-five consecutive patients with advanced prostate cancer underwent [¹¹C]Choline-PET/CT between 5/2004 and 2/2006.

Results

Overall, 295 lesions were detected: PET alone, 178 lesions; diagnostic CT, 221 lesions; PET/CT (low-dose CT), 272 lesions; PET/CT (diagnostic CT), 295 lesions. Two thirds of the lesions were located in the bone; one third in the prostate, lymph nodes, periprostatic tissue and soft tissue (lung, liver). The use of diagnostic CT did not result in a statistically significant difference with respect to lesion localization certainty and lesion characterization (P=.063, P=.063). PET-negative but PET/CT-positive lesions were mostly localized in the bone (78%, 91/117) as were PET-positive and CT-negative lesions (72%, 53/74). Of the latter, 91% (48/53) represented bone marrow and 9% (5/53) cortical involvement.

Conclusions

Staging and restaging with [¹¹C]Choline PET/CT in patients with advanced prostate cancer improve the assessment of local and regional recurrent as well as metastatic disease including skeletal manifestations. [¹¹C]Choline PET/CT (with a low-dose CT) results in improved localization and lesion characterization. [¹¹C]Choline PET/CT provides an added value for skeletal manifestations. [¹¹C]Choline PET/CT changed disease management in 11 (24%) of 45 patients with advanced prostate cancer.

Keywords: Advanced prostate cancer, Bone metastases, Choline, PET/CT