title: [11C]Choline PET/CT in therapy response assessment of a neoadjuvant therapy in locally advanced and high risk prostate cancer before radical prostatectomy.
abstract: OBJECTIVE
  Recent studies have shown promising results of neoadjuvant therapy in prostate cancer (PC). The aim of this study was to evaluate the potential of [11C]Choline PET/CT in therapy response monitoring after combined neoadjuvant docetaxel chemotherapy and complete androgen blockade in locally advanced and high risk PC patients.
  
  
  RESULTS
  In [11C]Choline PET/CT there was a significant decrease of SUVmax and SUVmean (p = 0.004, each), prostate volume (p = 0.005) and PSA value (p = 0.003) after combined neoadjuvant therapy. MRI showed a significant prostate and tumor volume reduction (p = 0.003 and 0.005, respectively). Number of apoptotic cells was significantly higher in prostatectomy specimens of the therapy group compared to pretherapeutic biopsies and the control group (p = 0.02 and 0.003, respectively).
  
  
  METHODS
  11 patients received two [11C]Choline PET/CT and MRI scans before and after combined neoadjuvant therapy followed by radical prostatectomy and pelvic lymph node dissection. [11C]Choline uptake, prostate and tumor volume, PSA value (before/after neoadjuvant therapy) and apoptosis (of pretherapeutic biopsy/posttherapeutic prostatectomy specimens of the therapy group and prostatectomy specimens of a matched control group without neoadjuvant therapy) were assessed and tested for differences and correlation using SPSS.
  
  
  CONCLUSIONS
  The results showing a decrease in choline uptake after combined neoadjuvant therapy (paralleled by regressive and apoptotic changes in histopathology) confirm the potential of [11C]Choline PET/CT to monitor effects of neoadjuvant therapy in locally advanced and high risk PC patients. Further studies are recommended to evaluate its use during the course of neoadjuvant therapy for early response assessment.
authors: Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.|Department of Nuclear Medicine, Rostock University Medical Centre, 18057 Rostock, Germany.
authors: Sarah M
authors: SM
authors: Schwarzenböck
authors: Department of Nuclear Medicine, Rostock University Medical Centre, 18057 Rostock, Germany.
authors: Anna
authors: A
authors: Knieling
authors: Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.|Department of Nuclear Medicine, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors: Michael
authors: M
authors: Souvatzoglou
authors: Department of Nuclear Medicine, Rostock University Medical Centre, 18057 Rostock, Germany.
authors: Jens
authors: J
authors: Kurth
authors: Institute of Pathology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.
authors: Katja
authors: K
authors: Steiger
authors: Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.
authors: Matthias
authors: M
authors: Eiber
authors: Institute of Pathology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.|Institute of Pathology, Heinrich-Heine University of Düsseldorf, 40225 Düsseldorf, Germany.
authors: Irene
authors: I
authors: Esposito
authors: Department of Urology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich.
authors: Margitta
authors: M
authors: Retz
authors: Department of Urology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich.
authors: Hubert
authors: H
authors: Kübler
authors: Department of Urology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich.
authors: Jürgen E
authors: JE
authors: Gschwend
authors: Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.
authors: Markus
authors: M
authors: Schwaiger
authors: Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.|Department of Nuclear Medicine, Rostock University Medical Centre, 18057 Rostock, Germany.
authors: Bernd J
authors: BJ
authors: Krause
authors: Department of Urology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich.
authors: Mark
authors: M
authors: Thalgott
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017209:Apoptosis; D001706:Biopsy; D002247:Carbon Isotopes / Q000737:chemistry; D002794:Choline / Q000737:chemistry*; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D000072078:Positron Emission Tomography Computed Tomography; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012306:Risk
chemical_list: D000970:Antineoplastic Agents; D002247:Carbon Isotopes; D017430:Prostate-Specific Antigen; D002794:Choline
keywords: PET/CT; choline; neoadjuvant therapy; prostate cancer; therapy response assessment