title: [11C]choline PET/CT impacts treatment decision making in patients with prostate cancer referred for radiotherapy.
abstract: BACKGROUND
  The purpose of our study was to analyze the role of [(11)C]choline-positron emission tomography/computed tomography (cho-PET/CT) in the management of patients with prostate cancer referred for radiotherapy.
  
  
  METHODS
  Inclusion criteria for this retrospective study were (1) presence of prostate cancer, (2) referral for first radiotherapy course (for primary or recurrent tumor) between February 2007 and July 2010, and (3) performance of cho-PET/CT. All cho-PET/CT scans were classified according to whether they were positive in the prostate/prostate bed (T), pelvic lymph nodes (N), and distant metastases (M) or negative. Therapeutic strategy based on the cho-PET/CT evaluation was compared with the strategy that would have been proposed had cho-PET/CT imaging not been available, following international and national prostate cancer guidelines.
  
  
  RESULTS
  Eighty-two cho-PET/CT scans performed in 74 patients were analyzed. Cho-PET/CT was positive in 49 studies (60%): T only in 22 (45% of all positive studies); N only in 4 (8%); T in combination with N in 3 (6%); and M in combination with T or N, or both, in 16 (33%). Treatment after positive cho-PET/CT examination included radiotherapy ± androgen deprivation (29 patients), surgery ± radiotherapy (6 patients), androgen deprivation only (8 patients), and other treatment (6 patients). In 22 cases, cho-PET/CT (27%) altered the treatment approach compared with the treatment that would have been adopted in the absence of cho-PET/CT analysis.
  
  
  CONCLUSIONS
  Cho-PET/CT is valuable in defining the extent of disease and supporting therapeutic decisions in the management of prostate cancer. The therapeutic strategy turned out to be influenced by cho-PET/CT imaging in about one third of the patients included in this study.
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
authors: Barbara Alicja
authors: BA
authors: Jereczek-Fossa
authors: Department of Nuclear Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors: Marcello
authors: M
authors: Rodari
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
authors: Maria
authors: M
authors: Bonora
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
authors: Paola
authors: P
authors: Fanti
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors: Cristiana
authors: C
authors: Fodor
authors: Department of Nuclear Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors: Giovanna
authors: G
authors: Pepe
authors: Department of Nuclear Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors: Egesta
authors: E
authors: Lopci
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors: Dario
authors: D
authors: Zerini
authors: Division of Radiation Oncology and Radiobiology, National Center for Oncological Hadrontherapy (CNAO) Foundation, Pavia, Italy. Electronic address: vischioni@cnao.it.
authors: Barbara
authors: B
authors: Vischioni
authors: Division of Radiation Oncology and Radiobiology, National Center for Oncological Hadrontherapy (CNAO) Foundation, Pavia, Italy; Department of Bioengineering, Politecnico di Milano, Milan, Italy.
authors: Guido
authors: G
authors: Baroni
authors: Department of Urology, European Institute of Oncology, Milan, Italy.
authors: Deliu Victor
authors: DV
authors: Matei
authors: Department of Urology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
authors: Ottavio
authors: O
authors: De Cobelli
authors: Department of Nuclear Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors: Arturo
authors: A
authors: Chiti
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Division of Radiation Oncology and Radiobiology, National Center for Oncological Hadrontherapy (CNAO) Foundation, Pavia, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
authors: Roberto
authors: R
authors: Orecchia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes; D002794:Choline; D003657:Decision Making; D019468:Disease Management; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D019275:Radiopharmaceuticals; D012017:Referral and Consultation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D002794:Choline
keywords: Choline PET; Prostate cancer; Radiotherapy; Recurrent tumor