title: [(11)C]choline PET/CT in prostate cancer patients with biochemical recurrence after radical prostatectomy.
abstract: OBJECTIVE
  To evaluate [(11)C]choline positron emission tomography/computed tomography ([(11)C]choline PET/CT) for the detection of a biochemical recurrence of prostate cancer after radical prostatectomy.
  
  
  METHODS
  Retrospective analysis of [(11)C]choline PET/CT performed in 41 consecutive prostate cancer patients with a rising PSA. The mean time to biochemical relapse was 24 months. PSA levels were determined at time of examination, and patients received either a targeted biopsy or surgery. Histopathology reports served as reference for the evaluation of the [(11)C]choline PET/CT findings.
  
  
  RESULTS
  Mean PSA in [(11)C]choline PET/CT positive patients was 3.1 ng/ml (median 2.2 ng/ml, range 0.5-11.6 ng/ml) and 0.86 ng/ml in [(11)C]choline PET/CT negative patients (median 0.83 ng/ml, range 0.41-1.40 ng/ml). Six of 12 patients with PSA < 1.5 ng/ml [(11)C]choline PET/CT revealed a pathological uptake. Histopathology was positive in 6/12 patients in this group. At PSA levels ranging from 1.5 to 2.5 ng/ml all [(11)C]choline PET/CT were positive (n = 16), a positive histology was found in 12/16 patients (75%) and at PSA 2.5-5 ng/ml [(11)C]choline PET/CT was positive in 8/8 patients, confirmed by histology in 7/8 patients. Finally, at PSA higher than 5 ng/ml [(11)C]choline PET/CT identified 5/5 patients positive all confirmed by histology. The sensitivity of [(11)C]choline PET/CT for the detection of recurrence at PSA < 2.5 ng/ml was 89% with a positive predictive value of 72%.
  
  
  CONCLUSIONS
  [(11)C]choline PET/CT is useful for re-staging of prostate cancer in patients with rising PSA even at levels below 1.5 ng/ml. Our study confirms results from other published studies on [(11)C]choline PET/CT in prostate cancer relapse.
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: Joerg
authors.initials: J
authors.lastname: Simon
authors.forename: Richard E
authors.initials: RE
authors.lastname: Hautmann
authors.forename: M V
authors.initials: MV
authors.lastname: Cronauer
authors.forename: Kathrin
authors.initials: K
authors.lastname: Hohl
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Buck
authors.forename: Sven N
authors.initials: SN
authors.lastname: Reske
authors.forename: Felix M
authors.initials: FM
authors.lastname: Mottaghy
mesh_terms: D000368:Aged; D002794:Choline / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: C447081:methyl carbon-11 choline; D017430:Prostate-Specific Antigen; D002794:Choline