title: Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer.
abstract: OBJECTIVE
  To investigate the clinical value of (18)F-fluorocholine PET/CT (CH-PET/CT) in treatment decisions in patients with recurrent prostate cancer (rPCA).
  
  
  METHODS
  The study was a retrospective evaluation of 156 patients with rPCA and CH-PET/CT for restaging. Questionnaires for each examination were sent to the referring physicians 14-64 months after examination. Questions included information regarding initial extent of disease, curative first-line treatment, and the treatment plan before and after CH-PET/CT. Additionally, PSA values at diagnosis, after initial treatment, before CH-PET/CT and at the end of follow-up were also obtained from the questionnaires.
  
  
  RESULTS
  Mean follow-up was 42 months. The mean Gleason score was 6.9 at initial diagnosis. Initial treatment was: radical prostatectomy in 110 patients, radiotherapy in 39, and combined prostatectomy and radiotherapy in 7. Median PSA values before CH-PET/CT and at the end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, decreased or were below measurable levels in 108 patients. PSA levels increased in 48 patients. In 75 of the 156 patients (48%) the treatment plan was changed due to the CH-PET/CT findings. In 33 patients the therapeutic plan was changed from palliative treatment to treatment with curative intent. In 15 patients treatment was changed from curative to palliative. In 8 patients treatment was changed from curative to another strategy and in 2 patients from one palliative strategy to another. In 17 patients the treatment plan was adapted.
  
  
  CONCLUSIONS
  CH-PET/CT has an important impact on the therapeutic strategy in patients with rPCA and can help to determine an appropriate treatment.
authors.affiliation: Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland. jan.soyka@gmx.ch
authors.forename: Jan D
authors.initials: JD
authors.lastname: Soyka
authors.forename: Marco A
authors.initials: MA
authors.lastname: Muster
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Schmid
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schick
authors.forename: Raymond
authors.initials: R
authors.lastname: Miralbell
authors.forename: Sandra
authors.initials: S
authors.lastname: Jorcano
authors.forename: Kathrin
authors.initials: K
authors.lastname: Zaugg
authors.forename: Hans-Helge
authors.initials: HH
authors.lastname: Seifert
authors.forename: Patrick
authors.initials: P
authors.lastname: Veit-Haibach
authors.forename: Klaus
authors.initials: K
authors.lastname: Strobel
authors.forename: Niklaus G
authors.initials: NG
authors.lastname: Schaefer
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Husarik
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hany
mesh_terms: D000328:Adult; D000368:Aged; D002794:Choline / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: C516370:fluoromethylcholine; D017430:Prostate-Specific Antigen; D002794:Choline