title: Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer.
abstract: OBJECTIVE
  To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of (11)C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT).
  
  
  METHODS
  We included 185 patients with BCR after RP (PSA >0.2 ng/ml) or after EBRT (ASTRO definition). After injection of 400 MBq 11C-Choline i.v., a scan was made using the ECAT HR + PET camera with CT fusion images or Siemens mCT PET/CT. Biopsy-proven histology, confirmative imaging (CT or bone scan) and/or clinical follow-up (PSA) were used as composite reference. Statistical analysis was performed using PASW Statistics 18.
  
  
  RESULTS
  11C-Choline PET was positive in 124/185 cases (65%) (in 22/61 (36%) after RP, 102/124 (82%) after EBRT). In 79 patients a local recurrence was identified, and 45 patients showed locoregional metastases on PET/CT. In 20 cases a proven false-negative PET scan was observed. Positive PET scans were confirmed by histology in 87/124 (70%) cases, by confirmatory imaging in 34/124 (28%) and by clinical follow-up after salvage treatment in 3 (2%) cases. The ROC analysis to detect a recurrence showed significant difference in area under the curve (AUC) of tPSA 0.721(p < 0.001) and PSA velocity 0.730 (p < 0.001). PSA doubling time showed no significant difference with an AUC of 0.542 (p = 0.354). Detection rates are <50% in tPSA <2 ng/ml and/or PSA velocity <1 ng/ml/year.
  
  
  CONCLUSIONS
  Total serum PSA and PSA velocity have significant effect on the detection rates of 11C-Choline PET/CT in men with a BCR after RP or EBRT.
authors: Department of Urology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. m.rybalov@umcg.nl
authors: Maxim
authors: M
authors: Rybalov
authors: Anthonius J
authors: AJ
authors: Breeuwsma
authors: Anna M
authors: AM
authors: Leliveld
authors: Jan
authors: J
authors: Pruim
authors: Rudi A
authors: RA
authors: Dierckx
authors: Igle J
authors: IJ
authors: de Jong
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood* / Q000378:metabolism; D002250:Carbon Radioisotopes; D002794:Choline; D018450:Disease Progression; D006801:Humans; D007610:Kallikreins / Q000097:blood* / Q000378:metabolism; D008297:Male; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000378:metabolism; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy; D019275:Radiopharmaceuticals; D011878:Radiotherapy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen; D002794:Choline