PET/CT with 18F-choline after radical prostatectomy in patients with PSA ≤2 ng/ml. Can PSA velocity and PSA doubling time help in patient selection?

Agostino Chiaravalloti, Daniele Di Biagio, Mario Tavolozza, Ferdinando Calabria, Orazio Schillaci

Research output: Contribution to journalArticle


Purpose: To investigate the performance of 18F-fluorocholine (18F-FCH) PET/CT in relation to the prostate-specific antigen (PSA) kinetic indexes, PSA doubling time (PSAdt) and PSA velocity (PSAve), in detecting recurrent prostate cancer (PC) in a selected population of patients treated with radical prostatectomy and with PSA ≤2 ng/ml. Methods: The study group comprised 79 patients (mean age 70 ± 7 years, range 58 – 77 years) who had been treated with radical surgery 30 to 90 months previously and with biochemical failure (defined as a measurable serum PSA level) who were evaluated with 18F-FCH PET/CT. In order to establish the optimal threshold for PSAdt and PSAve, the diagnostic performance of PSA, PSAdt and PSAve were compared by receiver operating characteristic analysis. Results: In the population examined, PSA (mean ± SD) was 1.37 ± 0.44 ng/ml (range 0.21 – 2 ng/ml) before PET/CT examination, PSAdt was 10.04 ± 16.67 months and PSAve was 2.75 ± 3.11 ng/ml per year. 18F-FCH PET/CT was positive in 44 patients (55 %). PSAve and PSAdt were significantly different between patients with a positive and a negative 18F-FCH PET/CT scan. Thresholds of 6 months for PSAdt and 1 ng/ml per year for PSAve were selected. For PSAdt ≤6 months the detection rate (DR) was 65 %, and for PSAve >1 ng/ml per year the DR was 67 %. PSA values were not significantly different between patients with a positive and a negative PET/CT scan. Conclusion: The results of our study suggest that 18F-FCH PET/CT could be considered for the evaluation of patients with biochemical recurrence of PC and with low PSA levels. Fast PSA kinetics could be useful in the selection of these patients.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalEuropean Journal Of Nuclear Medicine
Publication statusAccepted/In press - Jan 21 2016



  • PET/CT
  • PSA
  • PSA doubling time
  • PSA kinetics
  • PSA velocity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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