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. 2013 Mar;139(3):521-8.
doi: 10.1007/s00432-012-1354-4. Epub 2012 Nov 27.

Predictive factors of [18F]-Choline PET/CT in 170 patients with increasing PSA after primary radical treatment

Beatrice Detti  1 , Silvia Scoccianti, Davide Franceschini, Samantha Cipressi, Sara Cassani, Donata Villari, Mauro Gacci, Alberto Pupi, Luca Vaggelli, Calogero Saieva, Maurizio Pertici, Lorenzo Livi, M Ceroti, Giulio Nicita, Marco Carini, Giampaolo Biti
Affiliations

Predictive factors of [18F]-Choline PET/CT in 170 patients with increasing PSA after primary radical treatment

Beatrice Detti et al. J Cancer Res Clin Oncol. 2013 Mar.

Abstract

Aim: The purpose of this study was to evaluate the potential usefulness of [18F]-Choline PET/CT in the restaging of prostate cancer patients, who presented a rising PSA.

Materials and methods: We evaluated 170 prostate cancer patients, previously radically treated, that were referred for restaging with [18F]-Choline PET/CT.

Results: A total of 129 patients (median PSA 4.29 ng/ml at relapse) showed one or more areas of high uptake on PET/CT scan, while 41 patients with a median PSA of 1.07 ng/ml at relapse showed negative PET/CT scans. No false negative was found, while 31 patients were identified as false positive. Specificity of Choline PET/CT in our series was 56.9 %, while sensibility was 100 %. At the time of restaging, a PSA value superior or equal to 1 ng/ml was found to be a statistically significant predictive factor of PET positivity, either at the univariate (p < 0.0001) and at the multivariate analysis (p < 0.0001).

Conclusions: Based on our findings, [18F]-Choline PET/CT is confirmed as a useful diagnostic tool to detect early recurrence, in patients with increasing PSA after primary treatment. However, in case of a mild increase in PSA, positive results must be validated with other techniques, as specificity and positive predictive value of [18F]-Choline PET/CT decrease with the lower values of PSA.

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Figures

Fig. 1
Fig. 1
[18F]-Choline PET/CT showed a local recurrence, in a patient with a PSA level of 1.34 ng/ml, 3 years after prostatectomy
Fig. 2
Fig. 2
[18F]-Choline PET/CT showed a lymph nodal recurrence, in a patient with a PSA level of 2.52 ng/ml, 4 years after radical radiotherapy
See this image and copyright information in PMC

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