Prostate cancer localization with 18fluorine fluorocholine positron emission tomography.
OBJECTIVE
We evaluated positron emission tomography (PET) with fluorine fluorocholine (F FCH) for the pretreatment localization of prostate cancer.


METHODS
A total of 17 patients with prostate cancer who had not yet received treatment for the disease underwent whole body PET following intravenous administration of 3.3 to 4 MBq/kg F FCH. PET findings were compared with the results of prostate sextant biopsy and other imaging studies, and the clinical course. Tracer uptake in prostate sextants was measured as a maximum standardized uptake value (SUVmax) and evaluated as a predictor of the prostate sextant biopsy result by ROC analysis.


RESULTS
Prostate sextants positive for malignancy on biopsy demonstrated significantly higher SUVmax than biopsy negative sextants (mean 5.5 vs 3.3, p <0.001). In all 6 cases in which biopsy identified malignancy on only 1 side of the prostate it was possible to identify correctly the affected side based on higher SUVmax. Area under the ROC curve for SUVmax as a discriminator of biopsy positive sextants was 0.86. In 2 patients PET demonstrated areas of abnormal uptake in the retroperitoneum. Computerized tomography confirmed the presence of retroperitoneal lymphadenopathy in these areas. In the 2 patients these lesions regressed following hormonal treatment for prostate cancer.


CONCLUSIONS
Malignant tumors in the prostate gland can be localized based on a standardized regional measurement of F FCH uptake. PET with F FCH is potentially useful for staging and localizing prostate cancer.
Kwee
Sandi A
SA
Hamamatsu/Queen's PET Imaging Center, Queen Emma Research Foundation, Queen's Medical Center, 1301 Punchbowl Street, Honolulu, Hawaii 96813, USA. skwee@queens.org
Coel
Marc N
MN
Lim
John
J
Ko
Jehoon P
JP
D000368:Aged; D000369:Aged, 80 and over; D002794:Choline / Q000031:analogs & derivatives*; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D002794:Choline