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11C-choline positron emission tomography for the evaluation after treatment of localized prostate cancer.
- Source :
-
European urology [Eur Urol] 2003 Jul; Vol. 44 (1), pp. 32-8; discussion 38-9. - Publication Year :
- 2003
-
Abstract
- Rationale: The evaluation of the efficacy of the treatment of men with prostate cancer is largely based on post treatment levels of PSA. An increase in PSA or biochemical recurrence is the first sign of recurrent disease and precedes a clinically detectable recurrence by months to years. Digital rectal examination and conventional imaging techniques are not sensitive to detect a local recurrence. A metabolic imaging technique, which is not dependent on anatomical distortions, could be of use. In this study we investigated 11C-choline positron emission tomography (PET) for the evaluation after treatment of localized prostate cancer.<br />Methods: Thirty-six patients with localized prostate cancer, treated by either radical prostatectomy (n=20) or by external beam radiotherapy (n=16) were studied with 11C-choline PET. The results of PET were compared with the results of histology and with clinical follow up.<br />Results: Fourteen patients had no biochemical failure after therapy. 11C-choline PET was true negative in 14/14 patients. Twenty-two patients had a biochemical failure. In the radical prostatectomy patients 11C-choline PET was true positive in 5/13 (38%) cases. In the external beam radiotherapy patients 11C-choline PET was true positive in 7/9 (78%). The recurrent tumor was confirmed by biopsy or by bone scan in eleven of the twelve true positive patients. In ten patients with a negative 11C-choline PET scan, no recurrent tumor could be proven yet clinically, by biopsy or during follow up.<br />Conclusion: 11C-choline PET is a feasible technique for evaluation of treatment for localized prostate cancer. The site of recurrence was detected correctly in 78% of the patients after external beam radiotherapy compared to 38% of the patients after radical prostatectomy. No positive PET scans were observed sofar in patients with a serum PSA <5ng/ml. Confirmatory studies and longer follow up are needed to determine the efficacy of 11C-choline PET compared to other imaging techniques.
- Subjects :
- Aftercare
Aged
Aged, 80 and over
Biopsy, Needle
Brachytherapy methods
Choline
Cohort Studies
Humans
Male
Middle Aged
Monitoring, Physiologic methods
Neoplasm Staging
Prognosis
Prostatectomy methods
Prostatic Neoplasms radiotherapy
Prostatic Neoplasms surgery
Radiopharmaceuticals
Sensitivity and Specificity
Neoplasm Recurrence, Local diagnostic imaging
Neoplasm Recurrence, Local pathology
Prostatic Neoplasms diagnostic imaging
Prostatic Neoplasms pathology
Tomography, Emission-Computed methods
Subjects
Details
- Language :
- English
- ISSN :
- 0302-2838
- Volume :
- 44
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European urology
- Publication Type :
- Academic Journal
- Accession number :
- 12814672
- Full Text :
- https://doi.org/10.1016/s0302-2838(03)00207-0