18F-Choline PET/CT and Prostate MRI for Staging Patients With Biochemical Relapse After Irradiation for Prostate Cancer.

Abstract

PURPOSE:

The aim of this study was to assess the value of combining MRI and F-fluorocholine (FCH) PET/CT for patients with a biochemical relapse (BR) after prostate radiotherapy or brachytherapy.

PATIENTS AND METHODS:

All patients with a BR (BR definition: nadir prostate-specific antigen, +2 ng/mL) had a multiparametric MRI and FCH PET/CT if there was no clinical sign of relapse. Identification of the relapse was considered positive if both imaging techniques were concordant or in case of pathological relapse confirmation.

RESULTS:

Sixty-five consecutive patients were analyzed. Initial treatment was external beam radiation therapy (EBRT; n = 40), surgery followed by EBRT (n = 11), or brachytherapy (n = 14). Gleason score was 6 in 23 patients, 7 in 35 patients, and 8 to 10 in 7 patients. Median prostate-specific antigen value at the time of relapse was 7.6 ng/mL. Determination of relapse location was identified in 46 patients (70.7%). Relapses were only local in 24 patients (37%), nodal in 16 (24.6%), and distant in 9 (14%). In 4 cases, MRI showed a local relapse not seen by FCH PET/CT. Among the 24 patients with an isolated local relapse, 13 underwent a confirmatory biopsy and 9 were positive. At the end, only 7 patients (11%) could have a salvage local treatment: cryotherapy of the prostate in 6 cases and 1 nodal EBRT.

CONCLUSIONS:

In case of BR after radiotherapy or brachytherapy, combining MRI and FCH PET/CT could identify the site of relapse in 70% of patients. This could facilitate the selection of the patients for local salvage treatment.

• Authors: Laurent Quero, Laetitia Vercellino, Eric de Kerviler, Pierre Mongiat-Artus, Stephane Culine, Pascal Merlet, Vincent Ravery, Paul Meria, Francois Desgrandchamps, Christophe Hennequin
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 40 Issue 11 Pg. e492-5 (Nov 2015) ISSN: 1536-0229 [Electronic] United States
• PMID: 26252326 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Radiopharmaceuticals
• fluoromethylcholine
• fluorocholine
• Choline

Topics

• Aged
• Case-Control Studies
• Choline (analogs & derivatives)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Multimodal Imaging
• Neoplasm Recurrence, Local (diagnostic imaging, pathology, radiotherapy)
• Positron-Emission Tomography
• Prostatic Neoplasms (diagnostic imaging, pathology, radiotherapy)
• Radiopharmaceuticals
• Tomography, X-Ray Computed