title: Fluorine-18-fluoroethylcholine PET/CT in the detection of prostate cancer: a South African experience.
abstract: OBJECTIVE
  Imaging with fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has, until recently provided disappointing results with low sensitivity ranging from 31%-64% in patients with well-differentiated prostate cancer (PC) at all prostatic specific antigen (PSA) levels while fluorine-18-fluoroethylcholine ((18)F-FECh) PET/CT showed about 85% sensitivity in restaging patients after relapse. We present our experience of the sensitivity of (18)F-FECh PET/CT in the early stages of PC.
  
  
  METHODS
  Fifty patients were prospectively recruited and imaged, of which 40 fulfilled all inclusion criteria. Our patients had an average age of 65.5 years. Fifteen patients were referred for initial staging, with the remaining 25 referred for restaging and all patients had histologically confirmed adenocarcinoma. Patients were imaged by (18)F-FECh PET/CT. Findings were evaluated qualitatively and quantitatively and compared to the results of histology, PSA, Gleason score and bone scintigraphy. The prostate SUVmax was also used.
  
  
  RESULTS
  Thirty-one patients demonstrated abnormal pelvic- and or extra- pelvic findings on (18)F-FECh PET/CT, which was consistent with malignant or metastatic involvement. The prostate SUVmax could not be used to predict the presence or absence of metastatic disease.
  
  
  CONCLUSIONS
  Findings of this paper suggest that (18)F-FECh PET/CT in 30/40 cases (estimated as 75%) was helpful in the initial staging, restaging and lymph node detection of patients with PC. The SUVmax was not helpful. We diagnosed more PC cases in our African-American patients as compared to the Caucasian patients.
authors.affiliation: University of Pretoria and Steve Biko Academic Hospital Private Bag X169, Pretoria, 0001, South Africa. mike.sathekge@up.ac.za.
authors.forename: Mariza
authors.initials: M
authors.lastname: Vorster
authors.forename: Moshe
authors.initials: M
authors.lastname: Modiselle
authors.forename: Thomas
authors.initials: T
authors.lastname: Ebenhan
authors.forename: Carl
authors.initials: C
authors.lastname: Wagener
authors.forename: That
authors.initials: T
authors.lastname: Sello
authors.forename: Jan Rijn
authors.initials: JR
authors.lastname: Zeevaart
authors.forename: Evelyn
authors.initials: E
authors.lastname: Moshokwa
authors.forename: Mike Machaba
authors.initials: MM
authors.lastname: Sathekge
mesh_terms: D001741:Black or African American; D000368:Aged; D002794:Choline / Q000031:analogs & derivatives*; D005462:Fluorine Radioisotopes; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology; D011786:Quality Control; D019275:Radiopharmaceuticals; D013019:South Africa; D014057:Tomography, X-Ray Computed / Q000379:methods*; D044465:White People
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; C448902:fluoroethylcholine; D002794:Choline