title: [11C]Choline PET/CT for targeted salvage lymph node dissection in patients with biochemical recurrence after primary curative therapy for prostate cancer. Preliminary results of a prospective study.
abstract: BACKGROUND
  In this prospective study we set out to investigate the diagnostic value of [(11)C]choline-PET/CT in patients with suspected lymph node metastases before salvage lymph node dissection.
  
  
  METHODS
  15 consecutive patients with rising PSA underwent [(11)C]choline-PET/CT and consecutive open salvage pelvic/retroperitoneal extended lymph node dissection due to uptake of [(11)C]choline in at least 1 lymph node. Mean age was 62.1 (range 53-73).
  
  
  RESULTS
  [(11)C]choline-PET/CT results were compared with the histopathology reports and clinical follow-up (mean 13.7 months, range 6-24). Mean time to progression was 23.6 months (range 4-81). [(11)C]choline uptake was observed in nodes along the external and internal and common iliac arteries and in the paraaortic region. A positive histology was reported in 8/15 patients. Only one patient had a PSA nadir of <0.1 ng/ml after salvage surgery. Another patient had stable disease with a PSA of 0.5 ng/ml. Three patients developed bone metastases during follow-up.
  
  
  CONCLUSIONS
  This interim analysis indicates that [(11)C]choline-PET/CT may be a useful technique in detection of lymph node metastases when rising PSA occurs after definite prostate cancer therapy. The presented cohort is limited in size, but there is still strong evidence that the patients benefit from [(11)C]choline-PET/CT and consecutive salvage lymph node dissection is rather small.
authors.affiliation: Department of Urology, University of Ulm, Ulm, Germany. ludwig.rinnab@uniklinik-ulm.de
authors.forename: Ludwig
authors.initials: L
authors.lastname: Rinnab
authors.forename: Felix M
authors.initials: FM
authors.lastname: Mottaghy
authors.forename: Joerg
authors.initials: J
authors.lastname: Simon
authors.forename: Bjoern G
authors.initials: BG
authors.lastname: Volkmer
authors.forename: Robert
authors.initials: R
authors.lastname: de Petriconi
authors.forename: Richard E
authors.initials: RE
authors.lastname: Hautmann
authors.forename: Markus
authors.initials: M
authors.lastname: Wittbrodt
authors.forename: Guenther
authors.initials: G
authors.lastname: Egghart
authors.forename: Peter
authors.initials: P
authors.lastname: Moeller
authors.forename: Norbert
authors.initials: N
authors.lastname: Blumstein
authors.forename: Sven
authors.initials: S
authors.lastname: Reske
authors.forename: Rainer
authors.initials: R
authors.lastname: Kuefer