title: [Diagnostic performance of bone scintigraphy and (11)C-Choline PET/CT in the detection of bone metastases in patients with biochemical recurrence of prostate cancer].
abstract: OBJECTIVE
  To compare bone scan (BS) with (11)C-Choline PET/CT for the detection of bone metastases in patients with biochemical recurrence of prostate cancer (PC).
  
  
  METHODS
  A total of 169 patients with biochemical recurrence of PC(PSA:2.4-58 ng/ml) who were referred for both exams (0-15 days-in-between) were included. Lesion-detection-rate per patients and lesions were analyzed for both BS and (11)C-Choline PET/CT. Metastasis diagnosis was reached by: biopsy, CT/(18)F-Fluoride PET/MRI confirmation, or evidence of progression in subsequent imaging procedures.
  
  
  RESULTS
  A total of 91 lesions were found to be active in BS and/or (11)C-choline PET/CT (40 patients), with 78 of which were metastatic. BS detected 38 blastic, 2 lytic and 10 non-CT-evident lesions. (11)C-Choline PET/CT detected 41 blastic, 4 lytic and 29 non-CT-evident lesions. BS and (11)C-Choline PET/CT sensitivities were 65.4% and 96.1%; specificities ere 38.5 and 92.3% (χ(2) 8.27, p<0.04). Both imaging techniques were negative in 118 patients. Tracer avid lesions were found in 51 patients: with 30/51 being BS and (11)C-Choline PET/CT concordant; in 21/51 patients had discordant lesions (kappa 0.712, p=0.00). Lesions were absolutely discordant in 10/19 patients,: 5 FN BS, 2 FP BS (degenerative changes; dysplasia), 1 FN (11)C-Choline PET/CT (blastic), 1 FP (11)C-Choline PET/CT (degenerative), 1 out of field-of-view lesion with (11)C-Choline PET/CT (tibia alone). (11)C-Choline PET/CT showed extraosseous involvement in 26/51 patients with bone metastases: 9 local recurrences, 5 infra-diaphragmatic-lymph-nodes, 2 supra-diaphragmatic, 5 local and infra-diaphragmatic, 4 infra- and supra-diaphragmatic, 1 supra-diaphragmatic and lung metastases.
  
  
  CONCLUSIONS
  (11)C-Choline PET/CT yielded better sensitivity and specificity than BS for the detection of bone involvement in patients with biochemical recurrence of PC and allowed extraosseous restaging, with an impact in the clinical management of these patients.
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España. Electronic address: jrgarcia@cetir.es.
authors.forename: J R
authors.initials: JR
authors.lastname: Garcia
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: C
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Valls
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Cozar
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Bassa
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Soler
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Alvarez-Moro
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Moragas
authors.affiliation: Unidad PET CETIR-ERESA, Esplugues, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Riera
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary*; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D002250:Carbon Radioisotopes; D002794:Choline; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000628:therapy; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D002794:Choline; D013669:Technetium Tc 99m Medronate
keywords: (11)C-Choline PET/CT; (11)C-colina PET/TAC; Biochemical recurrence; Bone metastases; Bone scintigraphy; Cáncer de próstata; Gammagrafía ósea; Metástasis óseas; Prostate cancer; Recidiva bioquímica