OBJECTIVES: The aim of the study was to assess the effects of neoadjuvant androgen deprivation (NAD) and radical prostate radiotherapy with concurrent androgen deprivation (RT-CAD) on prostatic [C]choline kinetics and thus develop methodology for the use of [C]choline-PET/computed tomography (CT) as an early imaging biomarker. MATERIALS AND METHODS: Ten patients with histologically confirmed prostate cancer underwent three sequential dynamic [C]choline-PET/CT pelvic scans: at baseline, after NAD and 4 months after RT-CAD. [C]Choline uptake was quantified using the average and maximum standardized uptake values at 60 min (SUV60,ave and SUV60,max), the tumour-to-muscle ratios (TMR60,max) and net irreversible retention of [C]choline at steady state (Kimod-pat). RESULTS: The combination of NAD and RT-CAD significantly decreased tumour [C]choline uptake (SUV60,ave, SUV60,max, TMR60,max or Kimod-pat) and prostate-specific antigen (PSA) levels (analysis of variance, P<0.001 for all variables). Although the magnitude of reduction in the variables was larger after NAD, there was a smaller additional reduction after RT-CAD. A wide range of reduction in tumour SUV60,ave (38-83.7%) and SUV60,max (22.2-85.3%) was seen with combined NAD and RT-CAD despite patients universally achieving PSA suppression (narrow range of 93.5-99.7%). There was good association between baseline SUV60,max and initial PSA levels (Pearson's r=0.7, P=0.04). The reduction in tumour SUV60,ave after NAD was associated with PSA reduction (r=0.7, P=0.04). This association occurred despite the larger reduction in PSA (94%) compared with SUV60,ave (58%). CONCLUSION: This feasibility study shows that [C]choline-PET/CT detects metabolic changes within tumours following NAD and RT-CAD to the prostate. A differential reduction in [C]choline uptake despite a global reduction in PSA following NAD and RT-CAD could provide prognostic information and warrants further evaluation as an imaging biomarker in this setting.
OBJECTIVES: The aim of the study was to assess the effects of neoadjuvant androgen deprivation (NAD) and radical prostate radiotherapy with concurrent androgen deprivation (RT-CAD) on prostatic [C]choline kinetics and thus develop methodology for the use of [C]choline-PET/computed tomography (CT) as an early imaging biomarker. MATERIALS AND METHODS: Ten patients with histologically confirmed prostate cancer underwent three sequential dynamic [C]choline-PET/CT pelvic scans: at baseline, after NAD and 4 months after RT-CAD. [C]Choline uptake was quantified using the average and maximum standardized uptake values at 60 min (SUV60,ave and SUV60,max), the tumour-to-muscle ratios (TMR60,max) and net irreversible retention of [C]choline at steady state (Kimod-pat). RESULTS: The combination of NAD and RT-CAD significantly decreased tumour [C]choline uptake (SUV60,ave, SUV60,max, TMR60,max or Kimod-pat) and prostate-specific antigen (PSA) levels (analysis of variance, P<0.001 for all variables). Although the magnitude of reduction in the variables was larger after NAD, there was a smaller additional reduction after RT-CAD. A wide range of reduction in tumour SUV60,ave (38-83.7%) and SUV60,max (22.2-85.3%) was seen with combined NAD and RT-CAD despite patients universally achieving PSA suppression (narrow range of 93.5-99.7%). There was good association between baseline SUV60,max and initial PSA levels (Pearson's r=0.7, P=0.04). The reduction in tumour SUV60,ave after NAD was associated with PSA reduction (r=0.7, P=0.04). This association occurred despite the larger reduction in PSA (94%) compared with SUV60,ave (58%). CONCLUSION: This feasibility study shows that [C]choline-PET/CT detects metabolic changes within tumours following NAD and RT-CAD to the prostate. A differential reduction in [C]choline uptake despite a global reduction in PSA following NAD and RT-CAD could provide prognostic information and warrants further evaluation as an imaging biomarker in this setting.
Authors: M Picchio; P Mapelli; V Panebianco; P Castellucci; E Incerti; A Briganti; G Gandaglia; M Kirienko; F Barchetti; C Nanni; F Montorsi; L Gianolli; S Fanti Journal: Eur J Nucl Med Mol Imaging Date: 2015-01-17 Impact factor: 9.236
Authors: Axel Wetter; Felix Nensa; Marcus Schenck; Philipp Heusch; Thorsten Pöppel; Andreas Bockisch; Michael Forsting; Thomas W Schlosser; Thomas C Lauenstein; James Nagarajah Journal: PLoS One Date: 2014-07-17 Impact factor: 3.240
Authors: Sarah M Schwarzenböck; Anna Knieling; Michael Souvatzoglou; Jens Kurth; Katja Steiger; Matthias Eiber; Irene Esposito; Margitta Retz; Hubert Kübler; Jürgen E Gschwend; Markus Schwaiger; Bernd J Krause; Mark Thalgott Journal: Oncotarget Date: 2016-09-27