11C-choline PET/CT identifies osteoblastic and osteolytic lesions in patients with metastatic prostate cancer.

Abstract

AIM:

The aim of this study was to compare C-choline PET/CT, prostate-specific antigen (PSA), PSA kinetics, and C-choline uptake in recurrent metastatic prostate cancer patients with osteoblastic and osteolytic bone metastases.

PATIENTS AND METHODS:

We retrospectively analyzed 140 patients with the following criteria: (a) positive bone lesions identified with C-choline PET/CT and validated as true positive by histology (14.2%), correlative imaging (33.4%), or clinical follow-up (52.4%); (b) after radical prostatectomy (67.9%) or primary radiotherapy (22.1%); (c) proven biochemical relapse with rising PSA levels; (d) no chemotherapy, zoledronic acid, or palliative bone external beam radiation therapy previously administrated during biochemical relapse; and (f) asymptomatic for bone pain. Lesions were categorized as osteoblastic, osteolytic, or bone marrow lesions. Patients were divided into osteoblastic and osteolytic patient groups.

RESULTS:

C-Choline PET/CT detected oligometastatic bone disease (1-3 lesions) in 98 (70%) of the 140 patients and multiple bone lesions in 42 (30%) of the 140 patients. By per-lesion analysis of 304 lesions, there were 184 osteoblastic, 99 osteolytic, and 21 bone marrow lesions.By per-patient analysis, 97 (69.3%) of the 140 patients were in the osteoblastic group, whereas 43 (30.7%) of the 140 patients were in the osteolytic group. Statistically significant differences in SUVmax (P < 0.001), fast PSA doubling time (P = 0.01), and PSA velocity (P = 0.01) were observed between osteoblastic (lower values) and osteolytic (higher values) groups. By multivariate analysis, fast PSA doubling time was a significant predictor for osteolytic lesions.

CONCLUSIONS:

We demonstrated differences in PSA kinetics and SUVmax between osteolytic and osteoblastic lesions. C-Choline PET/CT may identify patients that could benefit from early targeted therapies, depending on the type of bone lesions expressed.

• Authors: Francesco Ceci, Paolo Castellucci, Tiziano Graziani, Riccardo Schiavina, Sotirios Chondrogiannis, Rachele Bonfiglioli, Stefano Costa, Irene J Virgolini, Domenico Rubello, Stefano Fanti, Patrick M Colletti
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 40 Issue 5 Pg. e265-70 (May 2015) ISSN: 1536-0229 [Electronic] United States
• PMID: 25783519 (Publication Type: Journal Article)

Chemical References

• Carbon Radioisotopes
• Radiopharmaceuticals
• Choline

Topics

• Aged
• Aged, 80 and over
• Bone Neoplasms (diagnostic imaging, secondary)
• Carbon Radioisotopes
• Choline
• Humans
• Male
• Middle Aged
• Multimodal Imaging
• Positron-Emission Tomography
• Prostatic Neoplasms (diagnostic imaging, pathology)
• Radiopharmaceuticals
• Tomography, X-Ray Computed