Optimized protocol for (18)F-choline PET/CT in patients with biochemically relapsed prostate cancer: experiences on 250 consecutive cases.
OBJECTIVE
We review acquisition F-choline PET/CT methodology, evaluate a new F-choline acquisition protocol for prostate cancer (PC), and propose a standardized acquisition protocol on F-choline in PC patients.


METHODS
Two hundred fifty consecutive PC patients (mean age 72 years, mean PSA 7.9 ng/mL) were prospectively evaluated with F-choline PET/CT. An early scan of the pelvis (1 bed position of 4 minutes) was followed by a whole-body scan at 1 hour. Early and 1 delayed hour images of the pelvis were compared.


RESULTS
Twenty-one percent of patients (n = 57) with positive F-choline demonstrated abnormal local uptake; 18% of patients (n = 45) showed distant localization only; 23% of patients (n = 53) had both local and distant localization; 38% of patients (n = 38) did not show any pathological uptake. All early images showed absence of radioactive urine in ureters, bladder, or urethra with satisfactory visualization of the prostatic region. Considering the group of patients with local uptake only, the prostatic region uptake, confirmed by late images, was better visualized in the early phase in 32/57 cases (SUVmax 12.4 ± 3.2 vs. 7.3 ± 5.2, P <0.01). Instead distant lesions were visualized on both early and late images with similar uptakes values (SUVmax 9.8 ± 4.1 vs. 10.3 ± 4.5, P = N.S.).


CONCLUSIONS
Early F-choline images improve pelvic prostate cancer lesion clarity. All pathologic pelvic deposits (prostate, lymph nodes, bone) were visualized both in the early and late images.
From the *Department of Nuclear Medicine, PET/CT Centre, "Santa Maria della Misericordia Hospital", Rovigo, Italy; and †Department of Radiology, University of Southern California, Los Angeles, CA.
Sotirios
S
Chondrogiannis
Maria Cristina
MC
Marzola
Gaia
G
Grassetto
Lucia
L
Rampin
Arianna
A
Massaro
Patrick M
PM
Colletti
Domenico
D
Rubello
D000368:Aged; D002794:Choline; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods* / Q000592:standards; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012008:Recurrence; D012015:Reference Standards; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D017430:Prostate-Specific Antigen; D002794:Choline