engleski

F-18-choline PET/CT in initial staging of prostate cancer patients

The aim of this study is to evaluate the role and value of F-18 choline PET/CT in initial staging and primary evaluation of prostate cancer extent. Materials and Methods: Hundred consecutive patients were scanned with F- 18-choline PET/CT in from February 2012 to April 2018. Mean age of our patient population was 68 years (range 52 to 85 years). Mean PSA value at referral was 48, 4 ng/ml (range 4, 3 to 280, 6 ng/ml). Patients had prostate biopsy performed prior to the scan, and were diagnosed with prostate adenocarcinoma, 41 in the highrisk group. Functional imaging was proposed after equivocal or negative conventional imaging findings (abdominal and pelvic MSCT), and equivocal findings of Tc-99m MDP bone scintigraphy. Results of Tc-99m MDP bone scintigraphy were available in 82 patients, most of them positive or equivocal for metastases, 89%. Mean administered activity was 209 MBq of F-18 choline (2-3 MBq/kg, IASOCholine, IASON GmBH). After the F-18 FCH scan patients had a minimum 6- month follow-up, ranging from 6 to 60 months. Results: Twenty four patients had localized prostate cancer with no positive metastases, while the majority of patients, 76%, had an F-18 FCH PET/CT scan positive for metastatic disease. Eight patients had a single positive pelvic lymph node, with a short axis diameter smaller than 1 cm. The other 68 patients had FCH positive metastatic disease, in seminal vesicles, lymph nodes and/or bone metastases. Fifty-six patients had lymph node metastases, with the mean SUVmax value was 6, 4, ranging from 2 to 22. Twenty-five patients had bone metastases, with the mean value of SUVmax 10, 7 ; ranging from 3, 8 to 23, 3. Sixteen patients had pathological uptake in the seminal vesicles. In the follow-up period change of management was observed in about two-thirds of patients, with a surgical approach chosen in ten patients with no FCH positive metastases. The majority of our patient population had a combination of radiotherapy and hormonal therapy, 60 %. Bilateral orchidectomy was performed in 12 patients, and 6 of them had an added docetaxel chemotherapy. Mean PSA levels after six months of therapy and follow up was significantly lower than the baseline value, 2, 1 ng/ml, ranging from undetectably low to the maximum value of 79 ng/ml. Conclusion: F- 18- choline PET/CT provides clinicians with valuable information in the staging of prostate cancer. It has an important impact on therapeutic strategy, providing additional data necessary for the appropriate and individual patient management.

prostate cancer ; staging ; F-18-choline ; PET/CT

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