title: Combined 18F-fluorocholine and 18F-fluoride positron emission tomography/computed tomography imaging for staging of high-risk prostate cancer.
abstract: OBJECTIVE
  To investigate how often positron emission tomography/computed tomography (PET/CT) scans, with both (18)F-fluorocholine and (18)F-fluoride as markers, add clinically relevant information for patients with prostate cancer who have high-risk tumours and a normal or inconclusive planar bone scan.
  
  
  METHODS
  Patients with prostate cancer with prostate specific antigen (PSA) levels between 20 and 99 ng/mL and/or Gleason score 8-10 tumours, planned for treatment with curative intent based on routine staging with a negative or inconclusive bone scan, were further investigated with a (18)F-fluorocholine and a (18)F-fluoride PET/CT. None of the patients received hormonal therapy before the staging procedures were completed.
  
  
  RESULTS
  For 50 of the 90 included patients (56%) one or both PET/CT scans indicated metastases. (18)F-fluorocholine PET/CT indicated lymph node metastases and/or bone metastases in 35 patients (39%). (18)F-fluoride PET/CT was suggestive for bone metastases in 37 patients (41%). In 18 patients (20%) the PET/CT scans indicated widespread metastases, leading to a change in therapy intent from curative to non-curative. Of the patients with positive scans, 74% had Gleason score 8-10 tumours. Of the patients with Gleason score 8-10 tumours, 64% had positive scans.
  
  
  CONCLUSIONS
  PET/CT scans with (18)F-fluorocholine and (18)F-fluoride commonly detect metastases in patients with high-risk prostate cancer and a negative or inconclusive bone scan. For 20% of the patients the results of the PET/CT scans changed the treatment plan.
authors.affiliation: Section of Urology, Department of Surgery, Växjö County Hospital, Lund University, Sweden. henrik@kjolhede.se
authors.forename: Henrik
authors.initials: H
authors.lastname: Kjölhede
authors.forename: Göran
authors.initials: G
authors.lastname: Ahlgren
authors.forename: Helen
authors.initials: H
authors.lastname: Almquist
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.forename: Kerstin
authors.initials: K
authors.lastname: Lyttkens
authors.forename: Tomas
authors.initials: T
authors.lastname: Ohlsson
authors.forename: Ola
authors.initials: O
authors.lastname: Bratt
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D002794:Choline / Q000031:analogs & derivatives*; D005459:Fluorides; D005462:Fluorine Radioisotopes; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; C514960:fluorocholine; D002794:Choline; D005459:Fluorides