C-11 choline PET/CT boosts early prostate ca detection

Findings of a study by researchers in Italy suggest C-11 choline PET/CT could diagnose prostate cancer recurrence sooner than transrectal ultrasound, CT, MRI, or bone scintigraphy in patients who have undergone radical prostatectomy.

Up to 30% of patients with prostate cancer who have undergone radical prostatectomy will relapse within 10 years. The statistics are more discouraging for those treated with external-beam radiotherapy, as more than half will experience some form of recurrence within five years.

According to a research group from the University of Bologna led by Paolo Castellucci, MD, PET/CT with C-11 choline has emerged as a promising alternative.

“In most patients with biochemical relapse after radical prostatectomy, conventional imaging methods often return false-negative results,” Dr. Castellucci said. “Our study found that for some patients, PET/CT with choline can improve the detection of cancer soon after PSA levels are measured.”

The group retrospectively evaluated 190 patients with biochemical relapse after radical prostatectomy who underwent C-11 choline PET/CT. Patients were classified by PSA levels as well as PSA kinetic factors such as PSA velocity and PSA doubling time.

The investigators found that detection of cancer recurrence with whole-body choline PET/CT in patients with biochemical relapse after prostatectomy correlates significantly with PSA levels and PSA kinetics, particularly in patients with low PSA levels (J Nucl Med 50:1394-1400, 2009).

Although further studies are needed, C-11 choline PET/CT has the potential to become a one-stop test to identify patients with early relapse who have the best chances for curative treatment and recovery, the investigators wrote.