title: Long-term Results of a Comparative PET/CT and PET/MRI Study of 11C-Acetate and 18F-Fluorocholine for Restaging of Early Recurrent Prostate Cancer.
abstract: OBJECTIVE
  The aims of this study were to assess the intraindividual performance of F-fluorocholine (FCH) and C-acetate (ACE) PET studies for restaging of recurrent prostate cancer (PCa), to correlate PET findings with long-term clinical and imaging follow-up, and to evaluate the impact of PET results on patient management.
  
  
  METHODS
  Thirty-three PCa patients relapsing after radical prostatectomy (n = 10, prostate-specific antigen [PSA] ≤3 ng/mL), primary radiotherapy (n = 8, prostate-specific antigen ≤5 ng/mL), or radical prostatectomy + salvage radiotherapy (n = 15) underwent ACE and FCH PET-CT (n = 29) or PET-MRI (n = 4) studies in a randomized sequence 0 to 21 days apart.
  
  
  RESULTS
  The detection rate for ACE was 66% and for FCH was 60%. Results were concordant in 79% of the cases (26/33) and discordant in 21% (retroperitoneal, n = 5; pararectal, n = 1; and external iliac nodes, n = 1). After a median FU of 41 months (n = 32, 1 patient lost to FU), the site of relapse was correctly identified by ACE and FCH in 53% (17/32) and 47% (15/32) of the patients, respectively (2 M1a patients ACE+/FCH-), whereas in 6 of 32 patients the relapse was not localized. Treatment approach was changed in 11 (34.4%) of 32 patients and 9 (28%) of 32 patients restaged with ACE and FCH PET, respectively.
  
  
  CONCLUSIONS
  In early recurrent PCa, ACE and FCH showed minor discrepancies, limited to nodal staging and mainly in the retroperitoneal area, with true positivity of PET findings confirmed in half of the cases during FU. Treatment approach turned out to be influenced by ACE or FCH PET studies in one third of the patients.
authors.affiliation: From the *Radiation Oncology, University Hospital of Geneva, Geneva, Switzerland; †Radiation Oncology, University of Genoa, DISSAL, Genoa, Italy; ‡Nuclear Medicine, University Hospital of Geneva, Switzerland; §Radiation Oncology, Teknon Oncologic Institute, Barcelona, Spain; and ∥Faculty of Medicine, Geneva University, Geneva, Switzerland.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lamanna
authors.forename: Claire
authors.initials: C
authors.lastname: Tabouret-Viaud
authors.forename: Olivier
authors.initials: O
authors.lastname: Rager
authors.forename: Sandra
authors.initials: S
authors.lastname: Jorcano
authors.forename: Hans-Joerg
authors.initials: HJ
authors.lastname: Vees
authors.forename: Yann
authors.initials: Y
authors.lastname: Seimbille
authors.forename: Habib
authors.initials: H
authors.lastname: Zaidi
authors.forename: Osman
authors.initials: O
authors.lastname: Ratib
authors.forename: Franz
authors.initials: F
authors.lastname: Buchegger
authors.forename: Raymond
authors.initials: R
authors.lastname: Miralbell
authors.forename: Thomas
authors.initials: T
authors.lastname: Zilli
authors.forename: Valentina
authors.initials: V
authors.lastname: Garibotto
mesh_terms: D000085:Acetates; D000368:Aged; D002244:Carbon; D002794:Choline / Q000031:analogs & derivatives*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D000072078:Positron Emission Tomography Computed Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals
chemical_list: D000085:Acetates; D019275:Radiopharmaceuticals; C438206:carbon-11 acetate; C514960:fluorocholine; D002244:Carbon; D002794:Choline