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Effectiveness of 11C-choline PET/CT in prostate cancer surveillance. Rev Esp Med Nucl Imagen Mol 2023; 42:93-99. [PMID: 36427802 DOI: 10.1016/j.remnie.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/06/2022] [Accepted: 10/22/2022] [Indexed: 11/27/2022]
Abstract
AIM Our aim was to analyse the performance of [11C]choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/mL. MATERIAL AND METHODS Three hundred and twenty-nine [11C]choline PET/CT examinations from 191 patients (68.2 ± 7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated. PSA at study was 13.0 ± 84.2 ng/mL. Main initial treatment was radical prostatectomy (RP) in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20' after injection of 555-740 MBq of [11C]choline. Minimum follow-up was 12 months. RESULTS Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than RP compared to patients with RP (85.6% vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 [11C]choline PET/CT scans performed with PSA < 1 ng/mL, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. CONCLUSION [11C]choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA < 1 ng/mL. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment.
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Martínez-Rodríguez I, de Arcocha-Torres M, Gómez-de la Fuente F, Jiménez-Bonilla J, Sánchez-Salmón A, Martínez-Amador N, Mendi-Barcina V, Andrés-Pacheco J, Gutiérrez-González A, Pombo-López M, Bota-Bota A, Rodil-Gallego M, García-Ruiz A, Quirce R. Rendimiento de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Urso L, Rocca GC, Borgia F, Lancia F, Malorgio A, Gagliano M, Zanetto M, Uccelli L, Cittanti C, Ippolito C, Evangelista L, Bartolomei M. The Role of [ 18F]F-Choline PET/CT in the Initial Management and Outcome Prediction of Prostate Cancer: A Real-World Experience from a Multidisciplinary Approach. Biomedicines 2022; 10:biomedicines10102463. [PMID: 36289724 PMCID: PMC9598779 DOI: 10.3390/biomedicines10102463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 12/24/2022] Open
Abstract
Initial staging of prostate cancer (PCa) is usually performed with conventional imaging (CI), involving computed tomography (CT) and bone scanning (BS). The aim of this study was to analyze the role of [18F]F-choline positron emission tomography (PET)/CT in the initial management and outcome prediction of PCa patients by analyzing data from a multidisciplinary approach. We retrospectively analyzed 82 patients who were discussed by the uro-oncology board of the University Hospital of Ferrara for primary staging newly diagnosed PCa (median age 72 (56-86) years; median baseline prostate specific antigen (PSA) equal to 8.73 ng/mL). Patients were divided into three groups based on the imaging performed: group A = only CI; group B = CI + [18F]F-choline PET/CT; group C = only [18F]F-choline PET/CT. All data on imaging findings, therapy decisions and patient outcomes were retrieved from hospital information systems. Moreover, we performed a sub-analysis of semiquantitative parameters extracted from [18F]F-choline PET/CT to search any correlation with patient outcomes. The number of patients included in each group was 35, 35 and 12, respectively. Patients with higher values of initial PSA were subjected to CI + PET/CT (p = 0.005). Moreover, the use of [18F]F-choline PET/CT was more frequent in patients with higher Gleason score (GS) or ISUP grade (p = 0.013). The type of treatment performed (surgery n = 33; radiation therapy n = 22; surveillance n = 6; multimodality therapy n = 6; systemic therapy n = 13; not available n = 2) did not show any relationship with the modality adopted to stage the disease. [18F]F-choline PET/CT induced a change of planned therapy in 5/35 patients in group B (14.3%). Moreover, patients investigated with [18F]F-choline PET/CT alone demonstrated longer biochemical recurrence (BCR)-free survival (30.8 months) in comparison to patients of groups A and B (15.5 and 23.5 months, respectively, p = 0.006), probably due to a more accurate selection of primary treatment. Finally, total lesion choline kinase activity (TLCKA) of the primary lesion, calculated by multiplying metabolic tumor volume and mean standardized uptake value (SUVmean), was able to more effectively discriminate patients who had recurrence after therapy compared to those without (p = 0.03). In our real-world experience [18F]F-choline PET/CT as a tool for the initial management of PCa had a relevant impact in terms of therapy selection and was associated with longer BCR-free survival. Moreover, TLCKA of the primary lesion looks a promising parameter for predicting recurrence after curative therapy.
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Affiliation(s)
- Luca Urso
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | | | - Francesca Borgia
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Federica Lancia
- Oncology Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Antonio Malorgio
- Radiotherapy Unit, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Mauro Gagliano
- Hospital Radiology, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Mauro Zanetto
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Licia Uccelli
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Corrado Cittanti
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Carmelo Ippolito
- Oncology Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Laura Evangelista
- Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
- Correspondence: ; Tel.: +39-04-9821-1310; Fax: +39-04-9821-3308
| | - Mirco Bartolomei
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Ferrara, Italy
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Bajeot AS, Roumiguié M, Rébillard X, Descotes JL, Duguet C, Lebret T, Fournier G, Corbel L, Gamé X, Soulié M. [De novo or secondary metastatic prostate cancer management in France: Observational study from "sentinel multidisciplinary meeting" of the French Association of Urology]. Prog Urol 2022; 32:691-701. [PMID: 35787978 DOI: 10.1016/j.purol.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/05/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Metastatic prostate cancer (mPCa) is an heterogeneous disease. Metachronous mPCa (MM) seems to have a better prognosis than synchronous mPCa (SM). However, it is difficult to analyze their specificities from national registries. Data from the so-called "sentinel multidisciplinary meeting" (SMDM) would represent a "real life" data collection. The objective of this national pilot study was to evaluate the concept of SMDM through the description and comparison of the diagnosis, management and follow-up of patients with synchronous or metachronous mPCa in 2018. METHODS A survey covering clinical, biological, radiological data as well as treatment initiated and follow-up at 3 and 6 months was sent to the SMDM. All patients diagnosed with metastatic disease (SM or MM) between 01/01/2018 and 11/30/2018 were included. RESULTS In total, 780 patients from 39 centers were included, 408 SM and 372 MM. SM were more symptomatic and had a higher metastatic burden than MM. PET were mostly performed in MM without a prior standard staging. SM patients received more chemotherapy than MM patients whereas new generation androgen deprivation therapy was mostly given to MM patients. At 6 months, there were no more significant difference in clinical presentation between the two groups. CONCLUSION Specificities of SM and MM patients in terms of clinical presentation, metastatic burden and management were described, validating the concept of SMDM as a source of reliable informations. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- A-S Bajeot
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France.
| | - M Roumiguié
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | | | - J-L Descotes
- Service d'urologie, CHU de Grenoble, Grenoble, France
| | - C Duguet
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | - T Lebret
- Service d'urologie, hôpital Foch, Suresnes, France
| | - G Fournier
- Service d'urologie, CHU de Brest, Brest, France
| | - L Corbel
- Service d'urologie, hôpital privé des côtes d'Armor, Plérin, France
| | - X Gamé
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | - M Soulié
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
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Latge A, Heimburger C, Severac F, Meyer N, Somme F, Imperiale A. Impact of pelvic dynamic acquisition on final reading of 18 F-Fluorocholine positron emission tomography in patients with prostate adenocarcinoma: True need or unnecessary burden? J Med Imaging Radiat Oncol 2021; 66:324-331. [PMID: 34323005 DOI: 10.1111/1754-9485.13296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/11/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Despite the increasing use of 18 F-fluorocholine (18 F-FCH) positron emission tomography (PET) in patients with prostate cancer, the acquisition protocol remains debated. We have evaluated the influence of the pelvic dynamic phase on the final reading of whole-body 18 F-FCH PET, to assess the need for a two-stage protocol. Reading the physician's experience and patient's previous treatment profile was also considered as potential influencing factors on final PET interpretation. METHODS All 18 F-FCH PET/CT performed from January 2018 to September 2019 in patients with prostate cancer and including a pelvic dynamic phase followed by a delayed whole-body acquisition were retrospectively retrieved. PET/CT were analysed by one expert nuclear medicine physician and one resident. The whole-body scan was analysed blinded (first reading) and nonblinded from the results of the dynamic phase. RESULTS 221 consecutive PET/CT were selected from 201 patients previously treated by radical prostatectomy (n = 31), pelvic radiation therapy (n = 60), or both (n = 94). 24 patients had no previous treatments, and 12 benefited from other focal treatments. In the whole population, dynamic acquisition modified final interpretation of 32/221 scans (14.5%) for residents, 26 (11.8%) for experts and 19 (8.6%) for consensual reading. No influence of previous treatments was found. The availability of a dynamic phase would have been responsible for treatment modification in 5/221 scans (2.3%). Considering only the prostate bed, dynamic acquisition modified the final interpretation in 7/125 (5.6%) studies (consensual reading) from patients with previous prostatic surgery and 4/84 (4.8%) scans from patients without a history of prostatic surgical intervention. No significant influence of dynamic acquisition was found on the final PET interpretation on prostate lodge accordingly to previous prostatic surgery. CONCLUSION The dynamic phase changes the interpretation of 18 F-FCH PET in about 9% of cases and the therapeutic strategy in <3% of patients. The influence of the early phase reduces with physician experience. Patient's treatment profile does not appear to have a significant influence on the variability of interpretation, also including the prostate bed.
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Affiliation(s)
- Adrien Latge
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Céline Heimburger
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Francois Severac
- Public Health, Strasbourg University Hospitals, Strasbourg, France
| | - Nicolas Meyer
- Public Health, Strasbourg University Hospitals, Strasbourg, France.,ICube, UMR7357, University of Strasbourg, Strasbourg, France
| | - François Somme
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France.,Molecular Imaging - DRHIM, IPHC, UMR 7178, CNRS/University of Strasbourg, Strasbourg, France
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Ferrari M, Renard J, Pereira Mestre R, Bosetti DG, Stoffel F, Treglia G. Change of management by using hybrid imaging with radiolabelled choline in biochemical recurrent prostate cancer: a systematic review and a meta-analysis. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-020-00407-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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