¹¹C- or ¹⁸F-Choline PET/CT for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer

Abstract

Recurrence of prostate cancer is suspected when an increase in the prostate-specific antigen level is detected after radical treatment; the recurrence could be local relapse, distant relapse, or both. Differentiation between the two patterns of relapse is critical for choosing the proper treatment strategy. Choline PET/CT could be of help in discriminating patients with local, lymph node, and bone recurrences, thus having an impact on patient management.

Evaluation of tumor recurrences after radical prostatectomy using 18F-Choline PET/CT and 3T multiparametric MRI without endorectal coil: a single center experience

“…Patients with positive MRI and PET/CT findings had PSA values that were significantly greater than those observed in patients with negative findings on the imaging tests. In fact, although we only found an association between PSA values at the time of biochemical failure and MRI positivity, many studies have reported an association between PSA and choline PET/CT [22]. Thus, after RP, the optimal PSA cut-off level for choline PET/CT analysis seems to be between 1 and 2 ng/mL [23], while for MRI, the corresponding value appears to range from 0.3 to 0.54 ng/mL [5].…”

PET Tracer 18F-Fluciclovine Can Detect Histologically Proven Bone Metastatic Lesions: A Preclinical Study in Rat Osteolytic and Osteoblastic Bone Metastasis Models

“…The most widely used PET tracer for diagnosing PCa is 11 C-choline 6. 11 C-Choline-PET has been used for detecting osteolytic and osteoblastic metastatic lesions in patients with PCa 6; however, Nanni et al 36 recently reported that the T/BG ratios of 18 F-fluciclovine were greater than 11 C-choline in PCa relapse including bone metastasis.…”

“…11 C-Choline-PET has been used for detecting osteolytic and osteoblastic metastatic lesions in patients with PCa 6; however, Nanni et al 36 recently reported that the T/BG ratios of 18 F-fluciclovine were greater than 11 C-choline in PCa relapse including bone metastasis. We also showed that 14 C-fluciclovine was superior to 3 H-choline for detecting lesions in osteoblastic metastasis model.…”

“…Compared to bone scan, positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2- 18 F-fluoro-D-glucose ( 18 F-FDG) has the advantage of detecting metastatic sites, including osteolytic lesions; however, it is not helpful in the diagnosis of osteoblastic lesions because these lesions have fewer malignant cells than osteolytic lesions 5. Another PET tracer, 11 C/ 18 F-choline chloride ( 11 C/ 18 F-choline) shows high sensitivity and specificity for detecting bone metastasis of PCa 6; however, the relatively high uptake of 11 C/ 18 F-choline or 18 F-FDG by macrophages may cause false-positive imaging results 7. There are many reviews on the potential of 18 F-FDG-PET, 11 C/ 18 F-choline, and bone scan for the detection of bone metastases in patients with PCa and/or BCa 8-13.…”

The management impact of 68gallium-tris(hydroxypyridinone) prostate-specific membrane antigen (68Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer

“…More recently, positron emission tomography-computed tomography (PET-CT), with tracers such as 18 F-choline, has increasingly played a role in the management of these patients [5,6]. However, sensitivity is only moderate for This article is part of the Topical Collection on Oncology -Genitourinary * Meghana Kulkarni Mkulkarni1@gmail.com detecting nodal metastases [5] or in those with low PSA levels at biochemical recurrence (BCR) [7]. This has led to the investigation of more prostate-specific tracers with greater diagnostic accuracy.…”