Choline uptake with PET/CT for the initial diagnosis of prostate cancer: Relation to PSA levels, tumour stage and anti-androgenic therapy

Giampiero Giovacchini, Maria Picchio, Elisa Coradeschi, Vincenzo Scattoni, Valentino Bettinardi, Cesare Cozzarini, Massimo Freschi, Ferruccio Fazio, Cristina Messa

Research output: Contribution to journalArticle

Abstract

Purpose: The accuracy of positron emission tomography (PET)/CT with [ 11C]choline for the detection of prostate cancer is not well established. We assessed the dependence of [11C]choline maximum standardized uptake values (SUVmax) in the prostate gland on cell malignancy, prostate-specific antigen (PSA) levels, Gleason score, tumour stage and anti-androgenic hormonal therapy. Methods: In this prospective study, PET/CT with [11C]choline was performed in 19 prostate cancer patients who subsequently underwent prostatectomy with histologic sextant analysis (group A) and in six prostate cancer patients before and after anti-androgenic hormonal therapy (bicalutamide 150 mg/day; median treatment of 4 months; group B). Results: In group A, based on a sextant analysis with a [11C]choline SUVmax cutoff of 2.5 (as derived from a receiver-operating characteristic analysis), PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 72, 43, 64, 51 and 60%, respectively. In the patient-by-patient analysis, no significant correlation was detected between SUVmax and PSA levels, Gleason score or pathological stage. On the contrary, a significant (Pmax and anti-androgenic therapy both in univariate (r 2=0.24) and multivariate (r 2=0.48) analyses. Prostate [11C]choline uptake after bicalutamide therapy significantly (P11C]choline is not suitable for the initial diagnosis and local staging of prostate cancer. PET/CT with [11C]choline could be used to monitor the response to anti-androgenic therapy.

Original languageEnglish
Pages (from-to)1065-1073
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 2008

Keywords

  • [C]Choline
  • Anti-androgenic therapy
  • PET/CT
  • Prostate cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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