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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Diagnostic utility and therapeutic impact of PET/CT [18F]F-fluoromethylcholine i...
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Vol. 39. Issue 5.
Pages 284-291 (September - October 2020)
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Vol. 39. Issue 5.
Pages 284-291 (September - October 2020)
Original article
DOI: 10.1016/j.remnie.2020.07.006
Diagnostic utility and therapeutic impact of PET/CT [18F]F-fluoromethylcholine in the biochemical recurrence of prostate cancer
Utilidad diagnóstica e impacto terapéutico de la PET/TC con [18F]F-Fluormetilcolina en la recidiva bioquímica del cáncer de próstata
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N. Sánchez-Izquierdoa, I. Valduviecoc, M.J. Ribalb, F. Camposa, F. Casasc, C. Nicolaud,f, R. Salvadord,f, B. Melladoe, S. Jorcanoc, D. Fustera,f, P. Paredesa,f,
Corresponding author
pparedes@clinic.cat

Corresponding author.
a Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, Spain
b Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, Spain
c Servicio de Oncología Radioterápica, Hospital Clínic de Barcelona, Barcelona, Spain
d Servicio de Radiodiagnóstico, CDI, Hospital Clínic de Barcelona, Barcelona, Spain
e Servicio de Oncología Médica, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
f Facultad de Medicina, Universitat de Barcelona (UB), Barcelona, Spain
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Tables (4)
Table 1. Characteristics of the patients recruited (n = 108) and primary treatment received by the patients included in the study.
Table 2. Number of positive lesions according to their localization in choline PET/CT.
Table 3. Proportion of positive studies based on PSA values.
Table 4. Clinical impact on the therapeutic management of the patients.
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Abstract
Objective

To assess the diagnostic capability of PET/CT with [18F]F-Fluoromethylcholine in prostate cancer (PC) with biochemical recurrence and its therapeutic impact.

Material and methods

We included 108 patients, diagnosed with PC with biochemical criteria for recurrence. A PET/CT choline scan was performed by dynamic pelvic and whole body study at 60min post-tracer injection. The relationship between the positive studies and the PSA value was analysed by classifying patients into three groups (<1.2/1.2–2/>2ng/ml), and the diagnostic capacity was assessed with respect to pelvic MRI and the impact on the therapeutic decision.

Results

The location of recurrence was identified in 85 of 108 patients (78.7%): 34 local, 47 pelvic lymph nodes and 58 distant lesions, including retroperitoneal, mediastinal lymph nodes and distant organ lesions (bone and lung). Second tumors were diagnosed in 4 patients. No significant differences were found in the percentage of positive studies depending on primary treatment. Patients with PSA>2ng/ml showed a higher percentage of disease detection than patients with a lower PSA level, with significant differences (p<0.0001). PET/CT [18F]F-Choline was able to detect local disease, not previously known from MRI, in 29.41% of patients. PET/CT Choline had an impact on therapeutic management in 67 of 108 patients (62%).

Conclusions

PET/CT with [18F]F-Fluoromethylcholine is a useful tool in the detection of locoregional and disseminated disease of PC treated with suspicion of recurrence, providing a change in therapeutic management in 62% of patients.

Keywords:
PET/CT [18F]F-Choline
Prostate cancer
Biochemical recurrence
Resumen
Objetivo

Valorar la capacidad diagnóstica de la PET/TC con [18F]F-Fluormetilcolina en la recidiva bioquímica del cáncer de próstata (CP) y su impacto terapéutico.

Material y métodos

Se incluyeron 108 pacientes, diagnosticados de CP con criterios bioquímicos de recurrencia. Se realizó una PET/TC Colina mediante estudio dinámico de pelvis y estudio de cuerpo entero a los 60min postinyección del trazador. Se ha analizado la relación entre los estudios positivos y el valor del PSA clasificando a los pacientes en tres grupos (<1,2/1,2-2/>2ng/ml); se ha valorado la capacidad diagnóstica respecto a la RM pelviana y el impacto en la decisión terapéutica.

Resultados

Se identificó la localización de la recurrencia en 85 de 108 pacientes (78,7%): 34 local, 47 ganglionar pelviana y 58 lesiones a distancia, incluyendo ganglios retroperitoneales, mediastínicos y lesiones en órganos a distancia (hueso y pulmón). Se diagnosticaron segundos tumores en 4 pacientes. No se encontraron diferencias significativas en el porcentaje de estudios positivos dependiendo del tratamiento primario.

Los pacientes con PSA>2ng/ml mostraron un porcentaje de detección de enfermedad más alto que los pacientes con un nivel de PSA inferior, con diferencias significativas (p<0,0001).

La PET/TC [18F]F-Colina fue capaz de detectar enfermedad local, no conocida previamente por la RM, en el 29,41% de los pacientes. La PET/TC Colina tuvo impacto en el manejo terapéutico en 67 de 108 pacientes (62%).

Conclusiones

La PET/TC [18F]F-Fluormetilcolina es una herramienta útil en la detección de enfermedad locorregional y diseminada del CP tratado con sospecha de recurrencia, proporcionando un cambio de manejo terapéutico en un 62% de los pacientes.

Palabras clave:
PET/TC [18F]F-Colina
Cáncer de próstata
Recidiva bioquímica

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