title: Relationship between PSA kinetics and [18F]fluorocholine PET/CT detection rates of recurrence in patients with prostate cancer after total prostatectomy.
abstract: OBJECTIVE
  The aim of the present study was to identify prostate-specific antigen (PSA) threshold levels, as well as PSA velocity, progression rate and doubling time in relation to the detectability and localization of recurrent lesions with [(18)F]fluorocholine (FC) PET/CT in patients after radical prostatectomy.
  
  
  METHODS
  The study group comprised 82 consecutive patients with biochemical relapse after radical prostatectomy. PSA levels measured at the time of imaging were correlated with the FC PET/CT detection rates in the entire group with PSA velocity (in 48 patients), with PSA doubling time (in 47 patients) and with PSA progression (in 29 patients).
  
  
  RESULTS
  FC PET/CT detected recurrent lesions in 51 of the 82 patients (62%). The median PSA value was significantly higher in PET-positive than in PET-negative patients (4.3 ng/ml vs. 1.0 ng/ml; p < 0.01). The optimal PSA threshold from ROC analysis for the detection of recurrent prostate cancer lesions was 1.74 ng/ml (AUC 0.818, 82% sensitivity, 74% specificity). Significant differences between PET-positive and PET-negative patients were found for median PSA velocity (6.4 vs. 1.1 ng/ml per year; p < 0.01) and PSA progression (5.0 vs. 0.3 ng/ml per year, p < 0.01) with corresponding optimal thresholds of 1.27 ng/ml per year and 1.28 ng/ml per year, respectively. The PSA doubling time suggested a threshold of 3.2 months, but this just failed to reach statistical significance (p = 0.071).
  
  
  CONCLUSIONS
  In a study cohort of patients with biochemical recurrence of prostate cancer after radical prostatectomy there emerged clear PSA thresholds for the presence of FC PET/CT-detectable lesions.
authors.affiliation: Department of Nuclear Medicine, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Graute
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jansen
authors.forename: Christopher
authors.initials: C
authors.lastname: Ubleis
authors.forename: Michael
authors.initials: M
authors.lastname: Seitz
authors.forename: Markus
authors.initials: M
authors.lastname: Hartenbach
authors.forename: Michael Karl
authors.initials: MK
authors.lastname: Scherr
authors.forename: Sven
authors.initials: S
authors.lastname: Thieme
authors.forename: Paul
authors.initials: P
authors.lastname: Cumming
authors.forename: Katharina
authors.initials: K
authors.lastname: Klanke
authors.forename: Reinhold
authors.initials: R
authors.lastname: Tiling
authors.forename: Peter
authors.initials: P
authors.lastname: Bartenstein
authors.forename: Marcus
authors.initials: M
authors.lastname: Hacker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002794:Choline / Q000737:chemistry; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D007700:Kinetics; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology*; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D002794:Choline
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