title: Consequence of the introduction of routine FCH PET/CT imaging for patients with prostate cancer: a dual centre survey.
abstract: BACKGROUND
  Fluorocholine(18F) (FCH) was introduced at the beginning of April 2010 in France, Slovenia and three other EU member states for the localisation of bone metastases of prostate cancer with PET. The aim of the study was to compare the evolution of diagnostic imaging in patients with prostate cancer using a new radiopharmaceutical FCH, observed in France and in Slovenia, and to quantify the consequence of the results of new imaging modality on the detection rate of abnormal metastases and recurrences of prostate cancer.
  
  
  METHODS
  In two centres (France/Slovenia), a survey of the number of nuclear medicine examinations in patients with prostate cancer was performed, covering 5 quarters of the year since the introduction of FCH. For each examination, the clinical and biological circumstances were recorded, as well as the detection of bone or soft tissue foci.
  
  
  RESULTS
  Six hundred and eighty-eight nuclear medicine examinations were performed impatients with prostate cancer. Nuclear medicine examinations were performed for therapy monitoring and follow-up in 23% of cases. The number of FCH PET/CT grew rapidly between the 1(st) and 5(th) period of the observation (+220%), while the number of bone scintigraphies (BS) and fluoride(18F) PET/CTs decreased (-42% and -23% respectively). Fluorodeoxyglucose(18F) (FDG) PET/CT remained limited to few cases of castrate-resistant or metastatic prostate cancer in Paris. The proportion of negative results was significantly lower with FCH PET/CT (14%) than with BS (49%) or fluoride(18F) PET/CT (54%). For bone metastases, the detection rate was similar, but FCH PET/CT was performed on average at lower prostate-specific antigen (PSA) levels and was less frequently doubtful (4% vs. 28% for BS). FCH PET/CT also showed foci in prostatic bed (53% of cases) or in soft tissue (35% of cases).
  
  
  CONCLUSIONS
  A rapid development of FCH PET/CT was observed in both centres and led to a higher detection rate of prostate cancer lesions.
authors.affiliation: Department for nuclear medicine, University Medical Centre, Ljubljana, Slovenia.
authors.forename: Marina
authors.initials: M
authors.lastname: Hodolic
authors.affiliation: Médecine nucléaire, Hôpital Tenon, AP-HP, Paris, France ; Université Pierre et Marie Curie, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Michaud
authors.affiliation: Médecine nucléaire, Hôpital Tenon, AP-HP, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Huchet
authors.affiliation: Médecine nucléaire, Hôpital Tenon, AP-HP, Paris, France ; Comenius University, Bratislava, Slovakia.
authors.forename: Sona
authors.initials: S
authors.lastname: Balogova
authors.affiliation: Radiopharmacie, Hôpital Tenon, AP-HP, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Nataf
authors.affiliation: Médecine nucléaire, Hôpital Tenon, AP-HP, Paris, France.
authors.forename: Khaldoun
authors.initials: K
authors.lastname: Kerrou
authors.affiliation: Nuklearmedizin, Kassel Klinikum, Kassel, Germany.
authors.forename: Marika
authors.initials: M
authors.lastname: Vereb
authors.affiliation: Department for nuclear medicine, University Medical Centre, Ljubljana, Slovenia.
authors.forename: Jure
authors.initials: J
authors.lastname: Fettich
authors.affiliation: Médecine nucléaire, Hôpital Tenon, AP-HP, Paris, France ; Université Pierre et Marie Curie, Paris, France.
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Talbot
keywords: PET/CT; bone scintigraphy; fluoride(18F); fluorocholine (FCH); indication of imaging; prostate cancer