title: Predictive factors of [18F]-Choline PET/CT in 170 patients with increasing PSA after primary radical treatment.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the potential usefulness of [18F]-Choline PET/CT in the restaging of prostate cancer patients, who presented a rising PSA.
  
  
  METHODS
  We evaluated 170 prostate cancer patients, previously radically treated, that were referred for restaging with [18F]-Choline PET/CT.
  
  
  RESULTS
  A total of 129 patients (median PSA 4.29 ng/ml at relapse) showed one or more areas of high uptake on PET/CT scan, while 41 patients with a median PSA of 1.07 ng/ml at relapse showed negative PET/CT scans. No false negative was found, while 31 patients were identified as false positive. Specificity of Choline PET/CT in our series was 56.9 %, while sensibility was 100 %. At the time of restaging, a PSA value superior or equal to 1 ng/ml was found to be a statistically significant predictive factor of PET positivity, either at the univariate (p < 0.0001) and at the multivariate analysis (p < 0.0001).
  
  
  CONCLUSIONS
  Based on our findings, [18F]-Choline PET/CT is confirmed as a useful diagnostic tool to detect early recurrence, in patients with increasing PSA after primary treatment. However, in case of a mild increase in PSA, positive results must be validated with other techniques, as specificity and positive predictive value of [18F]-Choline PET/CT decrease with the lower values of PSA.
authors.affiliation: Radioterapia, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50144 Florence, Italy. beatrice.detti@unifi.it
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.forename: Davide
authors.initials: D
authors.lastname: Franceschini
authors.forename: Samantha
authors.initials: S
authors.lastname: Cipressi
authors.forename: Sara
authors.initials: S
authors.lastname: Cassani
authors.forename: Donata
authors.initials: D
authors.lastname: Villari
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.forename: Alberto
authors.initials: A
authors.lastname: Pupi
authors.forename: Luca
authors.initials: L
authors.lastname: Vaggelli
authors.forename: Calogero
authors.initials: C
authors.lastname: Saieva
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pertici
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
authors.forename: M
authors.initials: M
authors.lastname: Ceroti
authors.forename: Giulio
authors.initials: G
authors.lastname: Nicita
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D002794:Choline; D015331:Cohort Studies; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000032:analysis / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D015854:Up-Regulation
chemical_list: D005462:Fluorine Radioisotopes; D017430:Prostate-Specific Antigen; D002794:Choline