18F-Choline PET/CT scan in staging and biochemical recurrence in prostate cancer patients: Changes in classification and radiotherapy planning

Abstract

Objective: To evaluate the role of the ¹⁸F-Choline PET/CT in prostate cancer management when detecting distant disease in planning radiotherapy and staging and to evaluate the therapy changes guided by PET/TC results.

Material and methods: A retrospective evaluation was performed on ¹⁸F-Choline PET/CT scans of patients with prostate cancer. Staging and planning radiotherapy scans were selected in patients with at least 9 months follow up. There was a total of 56 studies, 33 (58.93%) for staging, and 23 (41.07%) for planning radiotherapy. All scans were obtained using a hybrid PET/CT scanner. The PET/CT acquisition protocol consisted of a dual-phase procedure after the administration of an intravenous injection of 296-370MBq of ¹⁸F-Choline.

Results: There were 43 out of 56 (76.8%) scans considered as positive, and 13 (23.2%) were negative. The TNM staging was changed in 13 (23.2%) scans. The PET/CT findings ruled out distant disease in 4 out of 13 scans, and unknown distant disease was detected in 9 (69.3%) scans.

Conclusions: ¹⁸F-Choline PET/CT is a useful technique for detecting unknown distant disease in prostate cancer when staging and planning radiotherapy. The inclusion of ¹⁸F-choline PET/CT should be considered in prostate cancer management protocols.

Keywords: Biochemical recurrence; Choline; Colina; Cáncer de próstata; Estadificación; PET/CT; PET/TC; Planificación de radioterapia; Prostate cancer; Radiotherapy planning; Recurrencia bioquímica; Staging.