title: 18F-Choline PET/CT and Prostate MRI for Staging Patients With Biochemical Relapse After Irradiation for Prostate Cancer.
abstract: OBJECTIVE
  The aim of this study was to assess the value of combining MRI and F-fluorocholine (FCH) PET/CT for patients with a biochemical relapse (BR) after prostate radiotherapy or brachytherapy.
  
  
  METHODS
  All patients with a BR (BR definition: nadir prostate-specific antigen, +2 ng/mL) had a multiparametric MRI and FCH PET/CT if there was no clinical sign of relapse. Identification of the relapse was considered positive if both imaging techniques were concordant or in case of pathological relapse confirmation.
  
  
  RESULTS
  Sixty-five consecutive patients were analyzed. Initial treatment was external beam radiation therapy (EBRT; n = 40), surgery followed by EBRT (n = 11), or brachytherapy (n = 14). Gleason score was 6 in 23 patients, 7 in 35 patients, and 8 to 10 in 7 patients. Median prostate-specific antigen value at the time of relapse was 7.6 ng/mL. Determination of relapse location was identified in 46 patients (70.7%). Relapses were only local in 24 patients (37%), nodal in 16 (24.6%), and distant in 9 (14%). In 4 cases, MRI showed a local relapse not seen by FCH PET/CT. Among the 24 patients with an isolated local relapse, 13 underwent a confirmatory biopsy and 9 were positive. At the end, only 7 patients (11%) could have a salvage local treatment: cryotherapy of the prostate in 6 cases and 1 nodal EBRT.
  
  
  CONCLUSIONS
  In case of BR after radiotherapy or brachytherapy, combining MRI and FCH PET/CT could identify the site of relapse in 70% of patients. This could facilitate the selection of the patients for local salvage treatment.
authors.affiliation: From the Departments of *Radiation Oncology, †Nuclear Medicine, ‡Radiology, §Urology, and ¶Medical Oncology, Hôpital Saint-Louis; and ¶Department of Urology, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Quero
authors.forename: Laetitia
authors.initials: L
authors.lastname: Vercellino
authors.forename: Eric
authors.initials: E
authors.lastname: de Kerviler
authors.forename: Pierre
authors.initials: P
authors.lastname: Mongiat-Artus
authors.forename: Stephane
authors.initials: S
authors.lastname: Culine
authors.forename: Pascal
authors.initials: P
authors.lastname: Merlet
authors.forename: Vincent
authors.initials: V
authors.lastname: Ravery
authors.forename: Paul
authors.initials: P
authors.lastname: Meria
authors.forename: Francois
authors.initials: F
authors.lastname: Desgrandchamps
authors.forename: Christophe
authors.initials: C
authors.lastname: Hennequin
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002794:Choline / Q000031:analogs & derivatives; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; C516370:fluoromethylcholine; C514960:fluorocholine; D002794:Choline