Choline PET or PET/CT and Biochemical Relapse of Prostate Cancer

Evangelista, Laura; Zattoni, Fabio; Guttilla, Andrea; Saladini, Giorgio; Zattoni, Filiberto; Colletti, Patrick M.; Rubello, Domenico

doi:10.1097/rlu.0b013e3182867f3c

Cited by 262 publications

(194 citation statements)

References 58 publications

Supporting

Mentioning

179

Contrasting

Unclassified

Order By: Relevance

“…32 O PSA é importante no seguimento destes doentes, detectando precocemente a recidiva bioquímica. Não permite, contudo, a identificação dos locais de doença, nomeadamente a distinção entre recidiva loco-regional ou à distân-cia ou entre lesão única ou doença disseminada, 33 informações fundamentais para a individualização da estratégia terapêutica. 34 A biópsia apresenta limitações devido à sua natureza invasiva e à possibilidade de erros de amostragem.…”

Section: Discussionunclassified

PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica

et al. 2016

View full text Add to dashboard Cite

Results:The overall sensitivity was 63.2% and 80.0% when PSA > 2 ng/mL. It was possible to identify distant disease in 28% of the patients. The sensitivity increased from 40.0%, in patients with low and intermediate risk, to 55.2% in high-risk patients. Without hormonal suppression therapy, the sensitivity was 61.8%, while in the group under this therapy, was 67.7%. Discussion: PET/CT with 18F-Fluorocholine provided important information even in patients with low levels of PSA, however, with significantly increased sensitivity in patients with PSA > 2 ng/mL. Sensitivity was higher in high-risk patients compared with low and intermediate risk patients, however, without a statistically significant difference. The hormone suppression therapy does not appear to influence uptake of 18F-Fluorocholine in patients resistant to castration. Conclusions: In this study, PET/CT with 18F-Fluorocholine showed good results in restaging patients with prostate cancer biochemical recurrence, distinguishing between loco regional and systemic disease, information with important consequences in defining the therapeutic strategy. Keywords: Fluorocholine; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals. INTRODUÇÃOO carcinoma da próstata (CaP) é, na Europa, a neoplasia maligna mais comum no sexo masculino e a segunda causa de morte por cancro, tendo-se assistido a um aumento significativo da sua incidência nas últimas décadas. 1Uma vez que a idade é um factor de risco bem estabelecido no CaP prevê-se que, com o aumento da esperança média de vida, esta doença se torne num problema de saúde pú-blica, cada vez mais relevante. 2Após a terapêutica com intuito curativo, o seguimento destes doentes baseia-se, sobretudo, no doseamento sé-rico do antigénio específico da próstata (PSA) e a recidiva bioquímica é um acontecimento relativamente frequente. Terapêuticas de salvação são reservadas para doentes com recidiva loco regional. Nos doentes com metastização à distância, o tratamento paliativo mais comum é a Terapêutica de Supressão Hormonal (TSH). 4 Contudo, tem-se assistido a uma progressão das terapêuticas disponíveis, com introdução de terapias individualizadas.

show abstract

Section: Discussionunclassified

PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica

et al. 2016

View full text Add to dashboard Cite

show abstract

“…They concluded a pooled diagnostic sensitivity of 85.6 per cent (95% CI = 60.6-100 per cent) and specificity of 92.6 per cent (36.4-100 per cent), comprising a nodal sensitivity of 100 per cent (90.5-100 per cent) and specificity of 81.8 per cent (48.2-97.7 per cent), and a prostatic fossa sensitivity of 75.4 per cent (66.9-82.6 per cent) and specificity of 82 per cent (68.6-91.4 per cent). 21 …”

Section: Recurrencementioning

confidence: 99%

“…20 The studies to date evaluating choline-PET/CT have been heterogeneous. Evangelista et al 21 have published a meta-analysis of 19 studies (1555 patients) examining choline-PET and PET/CT imaging at the time of disease recurrence. They concluded a pooled diagnostic sensitivity of 85.6 per cent (95% CI = 60.6-100 per cent) and specificity of 92.6 per cent (36.4-100 per cent), comprising a nodal sensitivity of 100 per cent (90.5-100 per cent) and specificity of 81.8 per cent (48.2-97.7 per cent), and a prostatic fossa sensitivity of 75.4 per cent (66.9-82.6 per cent) and specificity of 82 per cent (68.6-91.4 per cent).…”

Section: Recurrencementioning

confidence: 99%

Current status of choline‐PET and prostate cancer

Taylor

Kirby

Hughes

et al. 2014

Trends Urol & Men's Health

View full text Add to dashboard Cite

show abstract

“…In cases of biochemical failure after primary treatment, the accuracy of CHO in localizing recurrent disease has been extensively reported, but mainly in retrospective studies [6,13]. The higher the PSA level and the shorter the PSA doubling time, the better will be the predictive value of this imaging modality [14].…”

mentioning

confidence: 99%

“…Among the different PET tracers proposed for PCa, choline derivatives are the most commonly used, especially in patients with biochemical failure [6]. Acetate and CHO have comparable accuracy in visualizing PCa, but most of the recent studies have focused on CHO [7].…”

mentioning

confidence: 99%

Writing PET into existence

Chiti

Kirienko

Incerti

et al. 2013

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

In this issue of the EJNMMI, a study evaluating a promising new PET tracer for imaging prostate cancer (PCa), 68 Ga-PSMA (PSMA), is published [1]. The paper deals with a retrospective analysis in 37 patients with biochemical recurrence of PCa who underwent both 18 F-fluoromethylcholine (CHO) and PSMA PET/CT for the purpose of restaging. The aim of the study was to compare the diagnostic performance of the novel tracer with that of CHO. On a patient basis, the detection rates were 70.3 % and 86.5 % for CHO and PSMA, respectively. PSMA also showed a better performance at low PSA values. The authors conclude that PSMA PET/CT can detect PCa relapse and metastasis with significantly improved contrast when compared with CHO PET/CT. This advantage is related to higher tracer uptake by PCa lesions and low background signal, which allow the detection of small lymph node, bone and liver metastases. Although innovative and interesting, this study had some limitations: it was retrospective; few lesions were confirmed by histology; several criteria were used to validate the uptake areas; the results were compared against CHO PET/CT, which was considered as a standard even though this modality is not established; and, finally, the impact on patient management is not discussed.The limitations of the study preclude recommendation of this new radiopharmaceutical in oncological guidelines, a fate that has befallen many other promising PET tracers. This is a critical issue for the future of nuclear medicine and deserves a commentary. The way we introduce new radiopharmaceuticals into the clinical arena is highly influenced by published data and we believe that efforts are needed to enhance the impact of our reports in the world of oncology.Although many readers are well aware of PCa imaging, let us briefly summarize the state of the art of PET radiopharmaceuticals that are used to study PCa.PCa is a considerable health issue and has displayed an increasing incidence worldwide during the last decade [2] -a trend that justifies the burgeoning medical interest in this disease. We can say that PCa is studied as much in men as breast cancer is studied in, mostly, women. As always in oncology, accurate detection of disease spread is crucial for treatment decisions and imaging could play a major role in identifying tumour extension, provided that sufficient diagnostic accuracy is properly demonstrated. Of course, PET imaging is competing on many levels with other diagnostic modalities, but we will not cover these aspects. As a consequence of the great clinical interest in PCa, several PET radiopharmaceuti-

show abstract

Choline PET or PET/CT and Biochemical Relapse of Prostate Cancer

Cited by 262 publications

References 58 publications

PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica

PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica

Current status of choline‐PET and prostate cancer

Writing PET into existence

Contact Info

Product

Resources

About