Acknowledgment of characteristic bowel necrosis CT findings is crucial for determining the therapeutic attitude and the use of previous CT scans to compare the SMA diameter may help the radiologist to achieve an early diagnosis of NOMI in an often critically ill patient population. Advances in knowledge: Diagnosis of NOMI can be difficult in cases of partial mural ischaemia, thus objective data (diameter of the SMA) should be useful for the radiologist to include NOMI as the first diagnostic option in the differential diagnosis.

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Background. Choline positron emission tomography (PET)/computed tomography (CT) is a currently used diagnostic tool in restaging prostate cancer (PCa) patients with increasing prostate-specific antigen (PSA) after either radical prostatectomy (RP) and/or external-beam radiation therapy (EBRT). Purpose. To assess the accuracy of 11C-Choline PET/CT (Chol-PET/CT) for the detection of recurrences after biochemical failure (BF) in PCa patients treated with RP, EBRT or both, and to analyse its role as a guide for tailored therapeutic strategies. Methods. From March 2011 to February 2013, 44 studies 11C-Choline PET/CT were realized in PCa patients (p) with BF. All patients were enrolled in Gregorio Marañon Hospital (Madrid). Median age was 67.6 years [55-81]; median PSA before BF was 7.9 ng/mL [0.38-87]. Conventional imaging negative tests (CT, bone scan) and BF data make the indication to determinate the location of macroscopic/metabolic relapse. Results. Median BF free-survival was 30.5 months . The diagnostic accuracy of choline PET/CT in detecting sites of PCa relapse was 75%. 77% of them had been treated with initial RP and 10 patients (p) with primary EBRT. 22p showed metastases (68% nodal recurrences), 9p local recurrence and 3p had a second primary tumor. Salvage treatment options were lymphadenectomy (8p), androgen deprivation (5p), observation (4p), cryotherapy (4p) or chemotherapy (1p). Conclusion. 11C-Choline PET/CT is a useful tool in locating persistent or recurrence disease after BF when other imaging tests are negative. This technique could change the management approach for individualised treatment of recurrence.

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