title: Role of PET-CT with18F-fluorocholine in biochemical recurrence after treatment of prostate cancer with curative intent.
abstract: OBJECTIVE
  To analyse the ability of the PET-CT with18F-fluorocholine (18F-FCH) to detect disease on biochemical recurrence after treatment with curative intent. To determine the clinical variables that would be able to optimise the test's diagnostic yield.
  
  
  METHODS
  A retrospective study of PET-CTs with18F-fluorocholine performed on 61 patients with prostate cancer who had undergone treatment with curative intent and met the criteria for biochemical recurrence. The results of the PET-CT were categorised into positive or negative and were validated using pre-established criteria. The relationship between the result of the PET-CT and the initial PSA nadir, PSA trigger, rising PSA velocity (PSAva) and PSA doubling time (PSAdt). The relationship between the metastatic sites on the PET-CT and the remaining variables was analysed.
  
  
  RESULTS
  There was a 34.4% detection rate of the disease. The initial PSA, PSA nadir, PSA trigger and PSAva showed statistically significant differences according to the result of the PET-CT. The best discriminatory cut-off point between a positive or negative PET-CT for PSA trigger and PSAva was 3.5ng/ml and 0.25ng/ml/month respectively. The PSAdt was significantly lower in patients with remote disease compared to patients with localised disease (5.1 vs 16.8 months, P=.01). The probability that the PET-CT would detect remote disease vs localised disease was 3.2 times higher if the PSAdt was under 6 months (80% vs 20%, OR: 3.2, P=.02). In the multivariate analysis, only the initial PSA and not having undergone radical prostatectomy were demonstrated as independent predictive factors of a positive PET-CT result.
  
  
  CONCLUSIONS
  The PET-CT with18F-FCH can detect disease in a high percentage of patients with biochemical recurrence and provides information on its anatomical location. PSA kinetics and the patient's previous treatment are key variables in increasing the test's diagnostic.
authors.affiliation: UGC Urología, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria IBS Granada (IBS Granada Bio-Health Research Institute), Granada, España. Electronic address: nacho.puchesanz@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Puche-Sanz
authors.affiliation: UGC Medicina Nuclear, Complejo Hospitalario Universitario de Granada, Granada, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Triviño-Ibáñez
authors.affiliation: UGC Urología, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria IBS Granada (IBS Granada Bio-Health Research Institute), Granada, España.
authors.forename: F
authors.initials: F
authors.lastname: Vázquez-Alonso
authors.affiliation: UGC Medicina Nuclear, Complejo Hospitalario Universitario de Granada, Granada, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Llamas-Elvira
authors.affiliation: UGC Urología, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria IBS Granada (IBS Granada Bio-Health Research Institute), Granada, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Cózar-Olmo
authors.affiliation: UGC Medicina Nuclear, Complejo Hospitalario Universitario de Granada, Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Fernández
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002794:Choline / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: C514960:fluorocholine; D017430:Prostate-Specific Antigen; D002794:Choline
keywords: (18)F-fluorocholine positron emission tomography/computed tomography; Biochemical recurrence; Cáncer de próstata; Positron emission tomography/computed tomography; Prostate cancer; Recidiva bioquímica; Tomografía por emisión de positrones con (18)F-fluorocolina; Tomografía por emisión de positrones/tomografía computerizada