Daniela Barbara Husarik MD, Presenter: Nothing to Disclose

Daniel T Schmid MD, Abstract Co-Author: Nothing to Disclose

Raymond Miralbell MD, Abstract Co-Author: Nothing to Disclose

Hubert John MD, Abstract Co-Author: Nothing to Disclose

Christina Thuerl MD, Abstract Co-Author: Nothing to Disclose

Thomas Frank Hany MD, Abstract Co-Author: Nothing to Disclose

Evaluation of [18F]fluorocholine (FCH) PET/CT in preoperative staging and as an imaging modality to detect recurrent disease of prostate cancer(PC).

In 53 patients (mean age 64.23; 46-77) FCH PET/CT (GE Healthcare, Waukesha WI, USA) using a standard dose of 150 MBq FCH was performed. Thereof 34 patients with proven PC eligible for radical surgery (pT1a-pT2c, PSA 1.41-38.40, Gleason 5-10) were imaged for initial staging. 29 patients presented with biochemical recurrence of PC (PSA mean: 12.29, 0.36-100 ng/ml). PET/CT findings were correlated to histopathological findings, PSA follow-up after surgery or radiotherapy (RT) or other imaging findings.

In all cases at initial staging, FCH accumulation was seen in the prostate. 30 patients underwent surgery. Postoperative PSA levels remained 0.1 ng/ml (0.1-0.36) after surgery. In 21 patients lymphadenectomy (LAD) was performed (93 LN). In the only FCH-positive LN (1/93) histopathology (HP) showed a makrometastasis. HP revealed metastases smaller than 3mm in 4 FCH-negative LN. 3/35 patients showed osseous metastases proven by bone scan. In 7/29 patients at restaging with proven local recurrence (PSA drop after RT, biopsy, endorectal MR) no pathological FCH uptake was seen (PSA mean: 2.08; 0.36-4.77ng/ml). In 9 patients local pathological FCH was seen, in all 9 patients dropping PSA levels during RT proved local recurrence. In 9 patients FCH positive LN were seen. In 4/9 patients lymphadenectomy was performed and histopathological specimen proved metastases of PC in 3/4 cases. In 1/ 4 case (mediastinal FCH positive LN) HP revealed reactive changes. Three patients showed FCH positive osseous metastases proven by bone scan. The lowest PSA level where pathological FCH uptake was seen was 0.7 ng/ml. The highest PSA level where no pathological FCH uptake was seen was 4.77 ng/ml.

FCH-PET/CT at initial staging for prostate cancer shows promising results in N- and M staging. In recurrent prostate cancer, a PSA level of 2 ng/ml and above has to be considered to reliably localize disease using FCH-PET/CT.

Evaluation of [18F]fluorocholine (FCH) PET/CT in preoperative staging and as an imaging modality to detect recurrent disease of prostate cancer(PC).

In 53 patients (mean age 64.23; 46-77) FCH PET/CT (GE Healthcare, Waukesha WI, USA) using a standard dose of 150 MBq FCH was performed. Thereof 34 patients with proven PC eligible for radical surgery (pT1a-pT2c, PSA 1.41-38.40, Gleason 5-10) were imaged for initial staging. 29 patients presented with biochemical recurrence of PC (PSA mean: 12.29, 0.36-100 ng/ml). PET/CT findings were correlated to histopathological findings, PSA follow-up after surgery or radiotherapy (RT) or other imaging findings.

In all cases at initial staging, FCH accumulation was seen in the prostate. 30 patients underwent surgery. Postoperative PSA levels remained 0.1 ng/ml (0.1-0.36) after surgery. In 21 patients lymphadenectomy (LAD) was performed (93 LN). In the only FCH-positive LN (1/93) histopathology (HP) showed a makrometastasis. HP revealed metastases smaller than 3mm in 4 FCH-negative LN. 3/35 patients showed osseous metastases proven by bone scan. In 7/29 patients at restaging with proven local recurrence (PSA drop after RT, biopsy, endorectal MR) no pathological FCH uptake was seen (PSA mean: 2.08; 0.36-4.77ng/ml). In 9 patients local pathological FCH was seen, in all 9 patients dropping PSA levels during RT proved local recurrence. In 9 patients FCH positive LN were seen. In 4/9 patients lymphadenectomy was performed and histopathological specimen proved metastases of PC in 3/4 cases. In 1/ 4 case (mediastinal FCH positive LN) HP revealed reactive changes. Three patients showed FCH positive osseous metastases proven by bone scan. The lowest PSA level where pathological FCH uptake was seen was 0.7 ng/ml. The highest PSA level where no pathological FCH uptake was seen was 4.77 ng/ml.

FCH-PET/CT at initial staging for prostate cancer shows promising results in N- and M staging. In recurrent prostate cancer, a PSA level of 2 ng/ml and above has to be considered to reliably localize disease using FCH-PET/CT.

Husarik, D, Schmid, D, Miralbell, R, John, H, Thuerl, C, Hany, T, Staging and Restaging of Prostate Cancer with [18F]Fluorocholine PET/CT.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417054.html