title: Value of 11C-choline PET and PET/CT in patients with suspected prostate cancer.
abstract: OBJECTIVE
  The value and limitations of (11)C-choline PET and PET/CT for the detection of prostate cancer remain controversial. The aim of this study was to investigate the diagnostic efficacy of (11)C-choline PET and PET/CT in a large group of patients with suspected prostate cancer.
  
  
  METHODS
  Fifty-eight patients with clinical suspicion of prostate cancer underwent (11)C-choline PET (25/58, Siemens ECAT Exact HR+) or PET/CT (33/58, Philips Gemini) scanning. On average, 500 MBq of (11)C-choline was administered intravenously. Studies were interpreted by raters blinded to clinical information and other diagnostic procedures. Qualitative image analysis as well as semiquantitative SUV measurement was carried out. The reference standard was histopathological examination of resection specimens or biopsy.
  
  
  RESULTS
  Prevalence of prostate cancer in this selected patient population was 63.8% (37/58). (11)C-choline PET and PET/CT showed a sensitivity of 86.5% (32/37) and a specificity of 61.9% (13/21) in the detection of the primary malignancy. With regard to metastatic spread, PET showed a per-patient sensitivity of 81.8% (9/11) and produced no false positive findings.
  
  
  CONCLUSIONS
  Based on our findings, differentiation between benign prostatic changes, such as benign prostatic hyperplasia or prostatitis, and prostate cancer is feasible in the majority of cases when image interpretation is primarily based on qualitative characteristics. SUV(max) may serve as guidance. False positive findings may occur due to an overlap of (11)C-choline uptake between benign and malignant processes. By providing functional information regarding both the primary malignancy and its metastases, (11)C-choline PET may prove to be a useful method for staging prostate cancer.
authors.affiliation: Department of Nuclear Medicine, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany. Bernhard.Scher@med.uni-muenchen.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Scher
authors.forename: Michael
authors.initials: M
authors.lastname: Seitz
authors.forename: Wolfram
authors.initials: W
authors.lastname: Albinger
authors.forename: Reinhold
authors.initials: R
authors.lastname: Tiling
authors.forename: Michael
authors.initials: M
authors.lastname: Scherr
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Becker
authors.forename: Michael
authors.initials: M
authors.lastname: Souvatzogluou
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Gildehaus
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Wester
authors.forename: Stefan
authors.initials: S
authors.lastname: Dresel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002250:Carbon Radioisotopes; D002794:Choline; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D002794:Choline