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18F-choline PET/CT for early detection of metastases in biochemical recurrence following radical prostatectomy

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Abstract

Purpose

Salvage radiotherapy (SRT) for biochemical recurrence (BCR) following radical prostatectomy (RP) should if possible be added at a prostate-specific antigen (PSA) level of <1–2 ng/mL. The value of positron emission tomography combined with computed tomography (PET/CT) at such low PSA values is not defined. The purpose was to determine what proportion of a well-defined cohort of hormone-naïve patients who were candidates for early salvage radiotherapy had 18F-choline PET/CT findings suggesting metastases.

Materials and methods

Patients with untreated BCR following RP, PSA <2 ng/mL, and Gleason score ≥7 or PSA doubling time ≤6 months underwent 18F-choline PET/CT. Focal choline uptake in lymph nodes or skeletal sites was recorded.

Results

PET/CT indicated metastases in 16 (28 %) of 58 patients. In five (9 %) patients, the scans suggested bone metastases, and in 11 (19 %) patients, the scans suggested regional lymph node metastases only. For patients with PSA levels <1.0 ng/mL, the PET/CT scans indicated metastatic recurrence in 25 %.

Conclusions

18F-choline PET/CT may be valuable for selecting patients with BCR following RP for SRT or experimental treatment of oligometastases, even at low PSA values.

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Acknowledgments

This study has been funded by The Swedish Cancer Society (2012/475), Cancerstiftelsen Kronoberg, Region Skånes FoU-enhet, FoU Kronoberg and Philips.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Section of Urology, Department of Surgery, Växjö Hospital, Lund University, 351 85, Växjö, Sweden

    Henrik Kjölhede

  2. Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden

    Göran Ahlgren & Fredrik Liedberg

  3. Center for Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden

    Helen Almquist & Kerstin Lyttkens

  4. Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden

    Thomas Ohlsson

  5. Department of Urology, Helsingborg Hospital, Lund University, Helsingborg, Sweden

    Ola Bratt

Authors
  1. Henrik Kjölhede
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  2. Göran Ahlgren
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  3. Helen Almquist
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  4. Fredrik Liedberg
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  5. Kerstin Lyttkens
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  6. Thomas Ohlsson
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  7. Ola Bratt
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Correspondence to Henrik Kjölhede.

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Kjölhede, H., Ahlgren, G., Almquist, H. et al. 18F-choline PET/CT for early detection of metastases in biochemical recurrence following radical prostatectomy. World J Urol 33, 1749–1752 (2015). https://doi.org/10.1007/s00345-015-1547-y

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  • DOI: https://doi.org/10.1007/s00345-015-1547-y

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