title: (18)F-choline PET/CT for early detection of metastases in biochemical recurrence following radical prostatectomy.
abstract: OBJECTIVE
  Salvage radiotherapy (SRT) for biochemical recurrence (BCR) following radical prostatectomy (RP) should if possible be added at a prostate-specific antigen (PSA) level of <1-2 ng/mL. The value of positron emission tomography combined with computed tomography (PET/CT) at such low PSA values is not defined. The purpose was to determine what proportion of a well-defined cohort of hormone-naïve patients who were candidates for early salvage radiotherapy had (18)F-choline PET/CT findings suggesting metastases.
  
  
  METHODS
  Patients with untreated BCR following RP, PSA <2 ng/mL, and Gleason score ≥7 or PSA doubling time ≤6 months underwent (18)F-choline PET/CT. Focal choline uptake in lymph nodes or skeletal sites was recorded.
  
  
  RESULTS
  PET/CT indicated metastases in 16 (28 %) of 58 patients. In five (9 %) patients, the scans suggested bone metastases, and in 11 (19 %) patients, the scans suggested regional lymph node metastases only. For patients with PSA levels <1.0 ng/mL, the PET/CT scans indicated metastatic recurrence in 25 %.
  
  
  CONCLUSIONS
  (18)F-choline PET/CT may be valuable for selecting patients with BCR following RP for SRT or experimental treatment of oligometastases, even at low PSA values.
authors.affiliation: Section of Urology, Department of Surgery, Växjö Hospital, Lund University, 351 85, Växjö, Sweden. henrik.kjolhede@med.lu.se.
authors.forename: Henrik
authors.initials: H
authors.lastname: Kjölhede
authors.affiliation: Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Ahlgren
authors.affiliation: Center for Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Helen
authors.initials: H
authors.lastname: Almquist
authors.affiliation: Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.affiliation: Center for Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Lyttkens
authors.affiliation: Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ohlsson
authors.affiliation: Department of Urology, Helsingborg Hospital, Lund University, Helsingborg, Sweden.
authors.forename: Ola
authors.initials: O
authors.lastname: Bratt
mesh_terms: D000368:Aged; D002794:Choline; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017430:Prostate-Specific Antigen; D002794:Choline
keywords: Computed X-ray tomography; Metastasis; Positron emission tomography; Prostate cancer; Recurrence
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