Does Choline PET/CT Change the Management of Prostate Cancer Patients With Biochemical Failure?

Abstract

These early results suggest that labeled choline PET/CT imaging performed according to current NCCN guidelines may change management and improve care in prostate cancer patients with biochemical failure by identifying patients for referral for salvage radiation therapy, improving radiation planning, and delaying or avoiding use of androgen deprivation therapy.

11C-Choline PET/CT for restaging prostate cancer. Results from 4,426 scans in a single-centre patient series

“…In daily clinical practice, choline PET/CT has been shown to be of value in patient management, leading to a change in the management decision in approximately 50 % of patients [27][28][29]. However, despite a wide bibliography [23,26], there is still no consensus as to the proper indication for choline PET/CT in patients with BCR.…”

PET/CT with 11C-choline for evaluation of prostate cancer patients with biochemical recurrence: meta-analysis and critical review of available data

“…Of the 43 studies, 13 were excluded: patients without biochemical relapse but with advanced disease or assessed for primary staging, i.e. inclusion criteria not fulfilled (3 studies [17][18][19]); intervention not in the inclusion criteria (1 study [20]); outcome of interest not reported (4 studies [21][22][23][24]); and no reference standard reported (5 studies [25][26][27][28][29]). Finally, 29 studies with 2,686 participants were included (Fig.…”

Initial single-centre Canadian experience with 18F-fluoromethylcholine positron emission tomography-computed tomography (18F-FCH PET/ CT) for biochemical recurrence in prostate cancer patients initially treated with curative intent

“…This is lower than in other studies, which showed a change of treatment plan in 48-55% of patients. 23,24 These studies used retrospective questionnaires completed by treating physicians and were not blinded, in contrast to our study. This could possibly explain the difference between results.…”

“…16 Choline is an essential component of phospholipid membrane and demonstrates increased metabolism in PCa. 17 The limited short half-life of 11C-choline (20.3 [23][24][25] The primary objective of this study was to determine predictive factors (patient and PSA characteristics) for 18F-FCH PET/CT positivity in patients with biochemical failure after local treatment for PCa with curative intent. Secondary objectives were to evaluate the impact of PET/CT on patient management and to compare its value to standard imaging techniques.…”