Value of bimodal 18F-choline-PET/MRI and trimodal 18F-choline-PET/MRI/TRUS for the assessment of prostate cancer recurrence after radiation therapy and radical prostatectomy

Francesco Paparo, Arnoldo Piccardo, Lorenzo Bacigalupo, Andrea Romagnoli, Riccardo Piccazzo, Michela Monticone, Luca Cevasco, Fabio Campodonico, Giuseppe Maria Conzi, Giorgio Carmignani, Gian Andrea Rollandi

Research output: Contribution to journalArticlepeer-review


Between 27% and 53% of all patients who undergo radical prostatectomy (RP) or radiation therapy (RT) as the first-line treatment of prostate cancer (PCa) develop a biochemical recurrence. Imaging plays a pivotal role in restaging by helping to distinguish between local relapse and metastatic disease (i.e., lymph-node and skeletal metastases). At present, the most promising tools for assessing PCa patients with biochemical recurrence are multiparametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET)/computed tomography (CT) with radio-labeled choline derivatives. The main advantage of mpMRI is its high diagnostic accuracy in detecting local recurrence, while choline-PET/CT is able to identify lymph-node metastases when they are not suspicious on morphological imaging. The most recent advances in the field of fusion imaging have shown that multimodal co-registration, synchronized navigation, and combined interpretation are more valuable than the individual; separate assessment offered by different diagnostic techniques. The objective of the present essay was to describe the value of bimodal choline-PET/mpMRI fusion imaging and trimodal choline-PET/mpMRI/transrectal ultrasound (TRUS) in the assessment of PCa recurrence after RP and RT. Bimodal choline-PET/mpMRI fusion imaging allows morphological, functional, and metabolic information to be combined, thereby overcoming the limitations of each separate imaging modality. In addition, trimodal real-time choline-PET/mpMRI/TRUS fusion imaging may be useful for the planning and real-time guidance of biopsy procedures in order to obtain histological confirmation of the local recurrence.

Original languageEnglish
Pages (from-to)1772-1787
Number of pages16
JournalAbdominal Imaging
Issue number6
Publication statusPublished - Jan 13 2015


  • Choline
  • Fusion imaging
  • Magnetic resonance imaging
  • Positron emission tomography
  • Prostate cancer
  • Transrectal ultrasound

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Medicine(all)


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