CONTEXT: Choline positron emission tomography (PET)/computed tomography (CT) is a currently used diagnostic tool in restaging prostate cancer (PCa) patients with increasing prostate-specific antigen (PSA) after either radical prostatectomy (RP) or external-beam radiation therapy (EBRT). However, no final recommendations have been made on the use of this modality for patient management. OBJECTIVE: To critically analyse the current evidence for the use of choline PET/CT scanning in the management of patients with a progressive increase in PSA after radical treatment for PCa, evaluating its diagnostic accuracy in the detection of recurrences, the clinical predictors of positive PET/CT examinations, and the modalities' role as a guide for tailored therapeutic strategies. EVIDENCE ACQUISITION: Data on recently published (2003-2010) original articles, review articles, and editorials concerning the role of choline PET/CT in this scenario were analysed. EVIDENCE SYNTHESIS: The diagnostic accuracy of choline PET in detecting sites of PCa relapse has been investigated by several authors, and the overall reported sensitivity ranges between 38% and 98%. It has been demonstrated that choline PET technology's positive detection rate improves with increasing PSA values. The routine use of choline PET/CT cannot be recommended for PSA values <1 ng/ml. However, in addition to PSA serum value, PSA doubling time (PSA DT), and other clinical and pathologic features-including locally advanced tumour (pT3b-T4) or lymph node involvement at initial staging-should be considered to refer patients to choline PET/CT study. Choline PET/CT may be also proposed as a image guide either for experimental surgical or radiation therapy treatments. CONCLUSIONS: According to the current available data, choline PET/CT plays a role in the management of biochemical relapse. Its accuracy is correlated to PSA value, PSA DT, and other pathologic features. Choline PET/CT may be proposed as a guide for individualised treatment of recurrence.
CONTEXT: Choline positron emission tomography (PET)/computed tomography (CT) is a currently used diagnostic tool in restaging prostate cancer (PCa) patients with increasing prostate-specific antigen (PSA) after either radical prostatectomy (RP) or external-beam radiation therapy (EBRT). However, no final recommendations have been made on the use of this modality for patient management. OBJECTIVE: To critically analyse the current evidence for the use of choline PET/CT scanning in the management of patients with a progressive increase in PSA after radical treatment for PCa, evaluating its diagnostic accuracy in the detection of recurrences, the clinical predictors of positive PET/CT examinations, and the modalities' role as a guide for tailored therapeutic strategies. EVIDENCE ACQUISITION: Data on recently published (2003-2010) original articles, review articles, and editorials concerning the role of choline PET/CT in this scenario were analysed. EVIDENCE SYNTHESIS: The diagnostic accuracy of choline PET in detecting sites of PCa relapse has been investigated by several authors, and the overall reported sensitivity ranges between 38% and 98%. It has been demonstrated that choline PET technology's positive detection rate improves with increasing PSA values. The routine use of choline PET/CT cannot be recommended for PSA values <1 ng/ml. However, in addition to PSA serum value, PSA doubling time (PSA DT), and other clinical and pathologic features-including locally advanced tumour (pT3b-T4) or lymph node involvement at initial staging-should be considered to refer patients to choline PET/CT study. Choline PET/CT may be also proposed as a image guide either for experimental surgical or radiation therapy treatments. CONCLUSIONS: According to the current available data, choline PET/CT plays a role in the management of biochemical relapse. Its accuracy is correlated to PSA value, PSA DT, and other pathologic features. Choline PET/CT may be proposed as a guide for individualised treatment of recurrence.
Authors: Jan D Soyka; Marco A Muster; Daniel T Schmid; Burkhardt Seifert; Ulrike Schick; Raymond Miralbell; Sandra Jorcano; Kathrin Zaugg; Hans-Helge Seifert; Patrick Veit-Haibach; Klaus Strobel; Niklaus G Schaefer; Daniela B Husarik; Thomas F Hany Journal: Eur J Nucl Med Mol Imaging Date: 2012-03-14 Impact factor: 9.236
Authors: David M Schuster; Bital Savir-Baruch; Peter T Nieh; Viraj A Master; Raghuveer K Halkar; Peter J Rossi; Melinda M Lewis; Jonathon A Nye; Weiping Yu; F DuBois Bowman; Mark M Goodman Journal: Radiology Date: 2011-04-14 Impact factor: 11.105
Authors: Andrei Fodor; Andrea Lancia; Francesco Ceci; Maria Picchio; Morten Hoyer; Barbara Alicja Jereczek-Fossa; Piet Ost; Paolo Castellucci; Elena Incerti; Nadia Di Muzio; Gianluca Ingrosso Journal: World J Urol Date: 2018-05-11 Impact factor: 4.226
Authors: Axel Heidenreich; Stefan Wilop; Michael Pinkawa; Daniel Porres; David Pfister Journal: Dtsch Arztebl Int Date: 2012-09-28 Impact factor: 5.594
Authors: Bhupesh Parashar; A Gabriella Wernicke; Samuel Rice; Joseph Osborne; Prabhsimranjot Singh; Dattatreyudu Nori; Shankar Vallabhajosula; Stanley Goldsmith; K S Clifford Chao Journal: Discov Med Date: 2012-07 Impact factor: 2.970