Prostate cancer: 1HMRS-DCEMR at 3T versus [(18)F]choline PET/CT in the detection of local prostate cancer recurrence in men with biochemical progression after radical retropubic prostatectomy (RRP)

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

“…Seven studies detailing the radiosynthesis of 18 F-FCH, preclinical and early clinical dosimetry and biodistribution in humans were identified. [20][21][22][23][24][25][26] Clinical studies included six articles for evaluation of local disease, [27][28][29][30][31][32] five articles for evaluation of nodal disease, 30,[33][34][35][36] six articles for bone metastases, including evaluation of treatment response, 30,34,[37][38][39][40] 12 articles for biochemical recurrence 34,[36][37][38][40][41][42][43][44][45][46][47] and two articles evaluating 18 F-FCH in castrate-resistant patients. 39,48 Seven studies evaluated 18 F-FCH for defining intra-prostatic lesions or limited lymph node recurrence for dose-escalated radiotherapy.…”

“…20,21,24,34,35,37,38,42,57 Early time points for imaging (0-15 min post-intravenous injection) and/or delayed imaging time points (30,40,45,60, 90-120 and 65-200 min post-intravenous injection) have been also described in the published literature. 22,23,[27][28][29][30][31][32][33]36,39,40,41,[43][44][45][46][47][48][49][50][51][52][54][55][56] 34 16…”

“…In the setting of biochemical recurrence, generally the performance of 18 F-FCH PET/CT seems to be higher among patients with higher PSA at the time of recurrence, shorter PSA doubling time or higher initial Gleason grade. 34,[36][37][38][41][42][43][44][45][46][47] For instance, Cimitan et al 41 found positive 18 F-FCH scans in 54 patients examined for rising PSA post-radical prostatectomy (n ¼ 58), radical radiotherapy (n ¼ 21) or while on hormones (n ¼ 21). They noted that the 18 F-FCH scans were rarely (3/38) positive among patients with PSA o4 ng ml À1 and initial Gleason grade p7, whereas all patients with a PSA 44 ng ml À1 and Gleason score 47 had positive scans.…”

“…34,[41][42][43][44][45] This may reflect the fact that isolated local recurrence is more likely at lower PSA levels and these recurrences may be more difficult to detect owing to challenges in distinguishing between prostate bed uptake and bladder accumulation of tracer, particularly for small volume recurrences. 34,36,[41][42][43][44][45] For example, in a series of 84 PCa patients, Panebianco et al 46 noted superior performance of 3 T combined 1 H-MRI and MR spectroscopy vs 18 F-FCH PET/CT for small volume (mean diameter ¼ 6 mm) and low PSA value (0.2-2 ng ml À1 ) recurrences, but comparable performance for larger volume local recurrence (mean diameter ¼ 13.3 mm). Of note, 18 F-FCH PET/CT also detected bone and lymph node metastases in 18% (5/28) and 45% (25/56) of PCa patients with mean PSA values of 1.1 ng ml À1 and 1.9 ng ml À1 , respectively.…”

“…Of note, 18 F-FCH PET/CT also detected bone and lymph node metastases in 18% (5/28) and 45% (25/56) of PCa patients with mean PSA values of 1.1 ng ml À1 and 1.9 ng ml À1 , respectively. 46 Table 5 summarizes the literature data on 18 F-FCH PET/CT in recurrent prostate cancer.…”