In vivo uptake of [(11)C]choline does not correlate with cell proliferation in human prostate cancer as depicted by Ki-67. Our results suggest that a process other than proliferation is responsible for the uptake of [(11)C]choline in prostate cancer.

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Followup measurement of serum PINP and ICTP is useful in the early assessment of skeletal metastases in patients with prostate cancer regardless of the confounding role of androgen deprivation treatment. The bone formation marker is the most indicative.

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Total serum PSA and PSA velocity have significant effect on the detection rates of 11C-Choline PET/CT in men with a BCR after RP or EBRT.

123 Background: Restaging with PET-CT in biochemical recurrent prostate cancer after prostatectomy shows a higher frequency of (false) negative cases compared to restaging after EBRT. It is uncertain if this reflects low volume of disease and/or low grade as biopsies fail to prove recurrent cancer in 50% of cases. We followed the clinical course of men with recurrent prostate cancer (PCa) after radical prostatectomy and investigated treatment and survival. PET-CT data were correlated with clinical data, PSA kinetics and disease specific and overall survival. We also studied relative survival comparing an age matched group from the Central Dutch Statistical Office (CBS). Methods: 64 patients underwent 11C-Choline PET-CT on PSA relapse. All patients were initially treated with radical prostectomy and reached PSA nadir of <0.1ng/mL. Recurrent disease was defined as PSA <0.4ng/mL after nadir. Patients were either treated with watchful waiting, adjuvant radiotherapy and/ or androgen deprivation therapy based on individual assesments by the treating urologists. Chi-square, log-rank and Mann-Whitney-U tests were used to study this population Results: The 64 patients had median PSA of 1.4ng/mL. Median follow-up period of patients was 50 (6–124) months. Ten patients died during the course of follow-up of which 5 due to metastasized PCa. No significant differences were seen in age, time to recurrence, total PSA at recurrence and PET-CT results. Patients with abnormal PET had higher PSAVel (median 3.09 ng/mL/yr vs 10.17, p= 0.002) and and shorter PSADT (med 4.83 mo vs 0.53, p= 0.016). Median time to treatment was significantly lower in the PET-CT negative group. Age of patients at death from the whole group did not differ from the age of death in an age matched group. Disease specific survival was significantly higher in the PET-CT negative group (p0.05). Conclusions: A negative 11C-Choline PET-CT correlated with a higher disease specific survival and a lower treatment rate. Overall survival of the group was equal to the age matched cohort. No significant financial relationships to disclose.

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We conclude that in order to prevent false-negative choline PET/CT scans androgen deprivation should be withheld prior to scanning, especially in hormone-naïve patients.