Carolina Moreno Maldonado MD, Presenter: Nothing to Disclose

Jose Ferrer, Abstract Co-Author: Nothing to Disclose

Gemma Cuberas, Abstract Co-Author: Nothing to Disclose

Marina Soler MD, PhD, Abstract Co-Author: Nothing to Disclose

Merce Moragas, Abstract Co-Author: Nothing to Disclose

Eduard Riera, Abstract Co-Author: Nothing to Disclose

Jose R. Garcia MD, Abstract Co-Author: Nothing to Disclose

To assess dual-phase 11C-choline PET/CT for differentiating benign from malignant lesions in patients with biochemical recurrence of prostate cancer

We prospectively studied 56 prostate cancer patients treated by surgery (n=22) or radiotherapy (n=34) who had hypermetabolic foci on 11C-choline PET/CT done for PSA recurrence (1.23-9.9ng/ml). We used the dual-phase technique, calculating the standardized uptake value (SUV) for early (SUVearly) and late (SUVdelay) acquisitions and the difference (SUVvariation) to determine whether tracer uptake remained stable/increased (accumulative pattern) or decreased (washout pattern). We used t-tests to compare means and ROC analysis (SUVearly/SUVdelay/SUVvariation vs benign/malignant)

We identified 106 hypermetabolic foci (34 local, 10 inguinal, 34 infradiaphragmatic, 14 supradiaphragmatic, 14 bone). We identified 34 local foci (8 post-prostatectomy and 26 post-radiotherapy). The 8 post-surgical foci had accumulative pattern and recurrence was confirmed (3 histology, 5 follow-up). Of the 26 post-radiotherapy foci, 3 had washout pattern and follow-up ruled-out recurrence; 23 had accumulative pattern and recurrence was confirmed (14 histology, 9 follow-up). The 10 inguinal foci had washout pattern and were reactive (3 histology, 7 follow-up). The 34 infradiaphragmatic foci had accumulative pattern and were malignant (34 follow-up). Of the 14 supradiaphragmatic foci, the 3 with washout pattern were benign (3 histology) and the 11 with accumulative pattern were malignant (11 histology). Of the 14 foci in bone, 2 had washout pattern and corresponded with signs of spondyloarthropathy. On the ROC analysis, SUVvariation best discriminated benign from malignant lesions (area 0,993) followed by SUVdelay (0,933) and finally SUVearly (0,665) 

Dual-phase PET/CT with 11C-choline is technically feasible despite this tracer’s short half-life and is useful for discriminating benign from malignant lesions. SUVvariation accurately discriminated between benign and malignant lesions.

Feasibility of delayed 11C-Choline imaging . New protocol reduces dosimetry. A single attenuation correction CT for both PET. Better discriminates benign or malignant , allows selection treatment. 

Moreno Maldonado, C, Ferrer, J, Cuberas, G, Soler, M, Moragas, M, Riera, E, Garcia, J, Dual-phase 11C-Choline PET/CT in the Early Evaluation of Prostate Cancer Recurrence.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007791.html