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Role of 11C-choline positron emission tomography/computed tomography in evaluating patients affected by prostate cancer with suspected relapse due to prostate-specific antigen elevation

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Abstract

Purpose

The aim of this study was to evaluate the accuracy of 11C-choline positron emission tomography/computed tomography (PET/CT) in restaging patients affected by prostate cancer and suspected relapse due to prostate-specific antigen (PSA) increase. We also aimed to determine a PSA cutoff that is most suited to the study in terms of best compromise between sensitivity and specificity. Secondary endpoints were a comparison between 11C-choline PET/CT and histological results, clinical findings, and radiological imaging (CT and magnetic resonance imaging).

Materials and methods

We retrospectively evaluated 210 patients (median ± SD age 70 ± 7 years) affected by prostate cancer who underwent 11C-choline PET/CT.

Results

11C-choline PET/CT imaging was positive in 116 (55.2%) patients and negative in 94 (44.8%). Receiver operating characteristic (ROC) analysis showed that the highest accuracy (sensitivity 76.8%, specificity 92.5%) for the whole population was achieved when the PSA level of 1.26 ng/ml level was used as the cutoff value for interpreting the results (P = 0.0001 and the area under the ROC curve AUC 0.897). For patients treated with surgery or surgery plus radiotherapy the cutoff was 0.81 ng/ml (sensitivity 73.2%, specificity 86.1%). For patients treated with radiotherapy alone, the cutoff was 2.0 ng/ml (sensitivity 81.8%, specificity 92.9%).

Conclusion

Our results indicate that 11C-choline PET/CT is a useful diagnostic tool in patients affected by prostate cancer and a relapsed PSA level. The highest accuracy for all patients is obtained with a PSA cutoff level of 1.26 ng/ml, above which the imaging study is performed (0.81 ng/ml for patients treated with surgery or surgery plus radiotherapy and 2.0 ng/ml for patients treated with radiotherapy alone).

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Brescia and Spedali Civili di Brescia, P.le Spedali Civili 1, Brescia, 25123, Italy

    Francesco Bertagna, Giovanni Bosio, Pierluigi Rossini & Claudio Pizzocaro

  2. Urology Department, Spedali Civili di Brescia, Brescia, Italy

    Muhannad Abuhilal & Marco Finamanti

  3. Department of Urology, University of Brescia, Brescia, Italy

    Claudio Simeone & Sergio Cosciani Cunico

  4. 1st Division of Radiology, Spedali Civili di Brescia, Brescia, Italy

    Emanuela Orlando

  5. Biomedical Technology Department, University of Brescia, Brescia, Italy

    Giorgio Biasiotto

  6. Health Physics Department, Spedali Civili di Brescia, Brescia, Italy

    Carlo Rodella

  7. Department of Nuclear Medicine, University of Brescia, Brescia, Italy

    Raffaele Giubbini

Authors
  1. Francesco Bertagna
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  2. Muhannad Abuhilal
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  3. Giovanni Bosio
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  4. Claudio Simeone
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  5. Pierluigi Rossini
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  6. Claudio Pizzocaro
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  7. Emanuela Orlando
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  8. Marco Finamanti
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  9. Giorgio Biasiotto
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  12. Raffaele Giubbini
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Correspondence to Francesco Bertagna.

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Bertagna, F., Abuhilal, M., Bosio, G. et al. Role of 11C-choline positron emission tomography/computed tomography in evaluating patients affected by prostate cancer with suspected relapse due to prostate-specific antigen elevation. Jpn J Radiol 29, 394–404 (2011). https://doi.org/10.1007/s11604-011-0570-1

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  • DOI: https://doi.org/10.1007/s11604-011-0570-1

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