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Evaluation of [ 11 C]‐choline positron‐emission/computed tomography in patients with increasing prostate‐specific antigen levels after primary treatment for prostate cancer
Author(s) -
Rinnab Ludwig,
Mottaghy Felix M.,
Blumstein Norbert M.,
Reske Sven N.,
Hautmann Richard E.,
Hohl Kathrin,
Möller Peter,
Wiegel Thomas,
Kuefer Rainer,
Gschwend Juergen E.
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07083.x
Subject(s) - medicine , prostate cancer , prostatectomy , positron emission tomography , histology , nuclear medicine , brachytherapy , prostate specific antigen , biopsy , prostate , urology , histopathology , radiology , cancer , radiation therapy , pathology
OBJECTIVE To evaluate [ 11 C]‐choline positron‐emission tomography (PET)/computed tomography (CT) for detecting clinical recurrence after primary treatment for prostate cancer. PATIENTS AND METHODS In all, 50 patients with prostate cancer who had had initial therapy (radical prostatectomy in 40, external beam radiation in three and interstitial brachytherapy in seven) had PET/CT using [ 11 C]‐choline in the presence of an increased or increasing prostate‐specific antigen (PSA) level. The mean (range) time to biochemical progression was 22 (2–136) months. Current PSA levels were determined in all patients at the time of examination. The results were correlated with the histopathology reports after targeted biopsy or surgery, and with the clinical follow‐up. RESULTS The mean (median, range) PSA level in patients with positive PET/CT was 3.62 (2.42, 0.5–13.1) ng/mL, and that in patients with a negative scan was 0.90 (0.95, 0.41–1.40) ng/mL. PET/CT was positive in seven of 13 patients with a PSA level of <1.5 ng/mL, and histology was positive in this group in nine. In 17 patients with PSA levels of 1.5–2.5 ng/mL PET/CT was positive in all and the histology was positive in 13; in 11 men with a PSA level of 2.5–5 ng/mL PET/CT was positive in all 11 and the histology was positive in 10; in nine men with PSA levels of >5 ng/mL PET/CT identified all as positive and the histology was positive in eight. The sensitivity at a PSA level of <2.5 ng/mL of PET/CT for detecting recurrence was 91% (95% confidence interval, 71–99%) with a specificity of 50% (16–84)%. CONCLUSION [ 11 C]‐choline PET/CT seems to be useful for re‐staging prostate cancer after curative therapy and with increasing PSA levels; this was verified by histological examination. We recommend this method at PSA levels of <2.5 ng/mL.