18F-fluorocholine for prostate cancer imaging: a systematic review of the literature

Bauman, Glenn; Belhocine, Tarik; Kovacs, Michael S.; Ward, Aaron D.; Beheshti, Mohsen; Rachinsky, Irina

doi:10.1038/pcan.2011.35

Cited by 136 publications

(91 citation statements)

References 57 publications

(177 reference statements)

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“…The most commonly used oncologic PET tracer, 18 F-FDG, shows limited sensitivity for the detection of androgen-dependent PCa (4). In contrast, encouraging results have been published using both 11 C-and 18 F-labeled choline derivatives as PET tracers for PCa (5)(6)(7)(8)(9).…”

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confidence: 93%

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Quantification of ¹⁸F-Fluorocholine Kinetics in Patients with Prostate Cancer

Geest

Metselaar²,

Storm³

2015

J Nucl Med

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Choline kinase is upregulated in prostate cancer, resulting in increased 18 F-fluoromethylcholine uptake. This study used pharmacokinetic modeling to validate the use of simplified methods for quantification of 18 F-fluoromethylcholine uptake in a routine clinical setting. Methods: Forty-minute dynamic PET/CT scans were acquired after injection of 204 ± 9 MBq of 18 F-fluoromethylcholine, from 8 patients with histologically proven metastasized prostate cancer. Plasma input functions were obtained using continuous arterial blood-sampling as well as using image-derived methods. Manual arterial blood samples were used for calibration and correction for plasma-to-blood ratio and metabolites. Time-activity curves were derived from volumes of interest in all visually detectable lymph node metastases. 18 F-fluoromethylcholine kinetics were studied by nonlinear regression fitting of several single-and 2-tissue plasma input models to the time-activity curves. Model selection was based on the Akaike information criterion and measures of robustness. In addition, the performance of several simplified methods, such as standardized uptake value (SUV), was assessed. Results: Best fits were obtained using an irreversible compartment model with blood volume parameter. Parent fractions were 0.12 ± 0.4 after 20 min, necessitating individual metabolite corrections. Correspondence between venous and arterial parent fractions was low as determined by the intraclass correlation coefficient (0.61). Results for image-derived input functions that were obtained from volumes of interest in bloodpool structures distant from tissues of high 18 F-fluoromethylcholine uptake yielded good correlation to those for the blood-sampling input functions (R 2 5 0.83). SUV showed poor correlation to parameters derived from full quantitative kinetic analysis (R 2 , 0.34). In contrast, lesion activity concentration normalized to the integral of the blood activity concentration over time (SUV AUC ) showed good correlation (R 2 5 0.92 for metabolite-corrected plasma; 0.65 for whole-blood activity concentrations). Conclusion: SUV cannot be used to quantify 18 F-fluoromethylcholine uptake. A clinical compromise could be SUV AUC derived from 2 consecutive static PET scans, one centered on a large blood-pool structure during 0-30 min after injection to obtain the blood activity concentrations and the other a whole-body scan at 30 min after injection to obtain lymph node activity concentrations.

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confidence: 93%

“…At 6 time points (5,10,15,20,30, and 40 min after injection), manual arterial blood samples were collected, while the blood sampler operation was briefly paused. In addition, manual venous blood samples were collected at 5, 15, and 30 min after injection.…”

Section: Data Acquisitionmentioning

confidence: 99%

Quantification of ¹⁸F-Fluorocholine Kinetics in Patients with Prostate Cancer

Geest

Metselaar²,

Storm³

2015

J Nucl Med

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“…For instance, 11 C-labeled choline, which has only a 20 min half-life, is primarily excreted via the hepatobiliary route. This means that the bladder has minimal activity reducing artifacts in the pelvis [21][22][23]. The short half of 11 C mandates that it be produced on site, requiring both a cyclotron and synthetic radiochemistry facilities.…”

Section: C-mentioning

confidence: 99%

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

et al. 2016

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Early detection of recurrent prostate cancer (PCa) is of paramount importance to deliver prompt and accurate therapy reducing the chance of progression to metastatic disease. However, current imaging modalities such as conventional computed tomography, MRI and PET scanning do not provide sufficient sensitivity, especially at lower prostate-specific antigen values. Moreover, biological characterization of PCa has become increasingly important to provide patient-specific therapy and current imaging poorly characterizes disease aggressiveness. The current uprise of novel PET tracers in recurrent and metastatic PCa shows promising, yet variable sensitivities and specificities in detection, indicating the need for further studies. In this review, we highlight current and new PET tracers that have been developed to improve the detection of recurrent and metastatic PCa. KEYWORDS• biochemical recurrenceProstate cancer (PCa) is the most common noncutaneous malignancy in American men with 180,890 new cases and 26,120 deaths estimated in 2016 alone [1]. Recent advances in detection, monitoring and treatment of the disease include the growing use of multiparametric MRI, transrectal ultrasound/fusion MRI-guided biopsies and new focal therapies. Primary definitive therapy options for PCa remain radiation therapy (RT) and radical prostatectomy (RP), which are used with curative intent, although both methods have improved over time. Despite the high success rates in primary treatment, 15-25% of patients still experience biochemical recurrence (BCR), following primary definitive therapy with RP or RT [2][3][4][5][6][7]. The definition of BCR varies between therapy methods. For instance, following RP a rising PSA above 0.2 ng/ml defines BCR whereas following RT BCR is defined as a PSA change of 2.0 ng/ml above the nadir following RT and is known as the Phoenix criteria [7]. As rising PSA in post primary therapy patients is an indicator of PCa BCR, close monitoring of serum PSA levels following treatment is critical [7,8]. In the case of BCR, early detection and initiation of therapy is a key to better long-term outcomes. Early intervention is associated with a lower rate of metastatic disease. Thus, accurate and early detection of recurrence leading to earlier treatment will aid in hindering the progression of BCR to metastatic disease.Multiple imaging modalities exist for the detection of recurrent PCa including computed tomography (CT), bone scintigraphy, MRI and PET. However, the need for more sensitive and specific imaging modalities to detect early recurrent and metastatic PCa has been prompted by evidence supporting early treatment. In addition to more sensitive and specific imaging, there has been a 'thrust' toward personalized and targeted management to discover disease phenotype and predict clinical outcomes earlier, which PET/CT has answered the call [9]. The future demands more For reprint orders, please contact: reprints@futuremedicine.com

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“…For the latter, multiparametric PET/MRI has been examined to a large extent with promising results (33). PET imaging of primary and metastatic prostate cancer is usually performed with choline tracers like 11 C-choline or 18 F-choline and is controversially discussed in the literature, as it shows some limitations in diagnostic accuracy (34). The feasibility of simultaneous PET/MRI in prostate cancer was recently demonstrated for both 11 C-choline and to the PET component and reported a comparable image quality of the PET images derived from PET/CT and PET/ MRI with identical numbers of PET positive lesions detected in PET/CT and PET/MRI.…”

Section: A B Cmentioning

confidence: 99%

Clinical applications of PET/MRI: current status and future perspectives

Nensa

Beiderwellen²,

Heusch³

et al. 2014

Diagn Interv Radiol

113

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Fully integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) scanners have been available for a few years. Since then, the number of scanner installations and published studies have been growing. While feasibility of integrated PET/MRI has been demonstrated for many clinical and preclinical imaging applications, now those applications where PET/MRI provides a clear benefit in comparison to the established reference standards need to be identified. The current data show that those particular applications demanding multiparametric imaging capabilities, high soft tissue contrast and/or lower radiation dose seem to benefit from this novel hybrid modality. Promising results have been obtained in whole-body cancer staging in non-small cell lung cancer and multiparametric tumor imaging. Furthermore, integrated PET/MRI appears to have added value in oncologic applications requiring high soft tissue contrast such as assessment of liver metastases of neuroendocrine tumors or prostate cancer imaging. Potential benefit of integrated PET/ MRI has also been demonstrated for cardiac (i.e., myocardial viability, cardiac sarcoidosis) and brain (i.e., glioma grading, Alzheimer's disease) imaging, where MRI is the predominant modality. The lower radiation dose compared to PET/computed tomography will be particularly valuable in the imaging of young patients with potentially curable diseases. However, further clinical studies and technical innovation on scanner hard-and software are needed. Also, agreements on adequate refunding of PET/MRI examinations need to be reached. Finally, the translation of new PET tracers from preclinical evaluation into clinical applications is expected to foster the entire field of hybrid PET imaging, including PET/MRI. B oth positron emission tomography (PET) and magnetic resonance imaging (MRI) are well-established imaging modalities that have been clinically available for more than 30 years. However, the combination of PET and computed tomography (CT) into PET/CT has heralded a new era of hybrid imaging driven by the rapid ascend of PET/CT and the decline of stand-alone PET. The integration of PET and CT into a hybrid system provided added value that exceeds the sum of its parts, in particular fast and accurate attenuation correction and the combination of anatomical and molecular information.Inspired by the vast success of PET/CT, the combination of PET and MRI was an obvious goal. Therefore initial solutions comprised the software based co-registration and post-hoc fusion (1) of independently acquired PET and MRI data, as well as shared tabletop sequential PET and MRI acquisition (2, 3). While the integration of PET and CT into a hybrid system was challenging but technically feasible, the integration of PET and MRI was considered extremely demanding, if not impossible. Two main technical challenges that had to be solved: in the first place development of a PET insert that is compatible to high magnetic field strengths normally used in MRI, and vice versa development ...

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18F-fluorocholine for prostate cancer imaging: a systematic review of the literature

Cited by 136 publications

References 57 publications

Quantification of ¹⁸F-Fluorocholine Kinetics in Patients with Prostate Cancer

Quantification of ¹⁸F-Fluorocholine Kinetics in Patients with Prostate Cancer

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

Clinical applications of PET/MRI: current status and future perspectives

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18F-fluorocholine for prostate cancer imaging: a systematic review of the literature

Cited by 136 publications

References 57 publications

Quantification of 18F-Fluorocholine Kinetics in Patients with Prostate Cancer

Quantification of 18F-Fluorocholine Kinetics in Patients with Prostate Cancer

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

Clinical applications of PET/MRI: current status and future perspectives

Contact Info

Product

Resources

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Quantification of ¹⁸F-Fluorocholine Kinetics in Patients with Prostate Cancer

Quantification of ¹⁸F-Fluorocholine Kinetics in Patients with Prostate Cancer