18F-Choline PET/CT or PET/MR and the evaluation of response to systemic therapy in prostate cancer: are we ready?

During the last decade, [18F]F-choline positron emission tomography (PET) had a rising role in prostate cancer (PCa) imaging. However, despite auspicious premises, [18F]F-choline PET is not currently recommended for the evaluation of response to therapy assessment in PCa, mainly due to the lack of large-scale prospective trials.

We report the cases of seven patients affected by PCa, in which [18F]F-choline PET (either with computed tomography-CT or magnetic resonance imaging-MR) contributed significantly in the systemic therapy response evaluation.

[18F]F-choline PET/CT or PET/MR demonstrated to be a useful imaging modality in the assessment of response to systemic therapy in metastatic PCa patients, irrespective of the stage of disease (either in hormone sensitive and in castrate resistant condition) and the kind of systemic treatment. In most cases, PSA serum values and [18F]F-choline PET showed a synchronous disease evolution after systemic therapy. ADT can alter [18F]F-choline uptake, therefore the time of scan should be correctly planned. Finally, PET/CT with [18F]F-choline is a useful tool for reinforcing the identification of metastatic disease in case of a switch from metastatic castration sensitive to castration resistant PCa.

Clinical and translational imaging. 2022 Jul 28 [Epub ahead of print]

Luca Urso, Federica Lancia, Naima Ortolan, Marta Frapoli, Martina Rauso, Paolo Artioli, Corrado Cittanti, Licia Uccelli, Antonio Frassoldati, Laura Evangelista, Mirco Bartolomei

Department of Translational Medicine, University of Ferrara, Ferrara, Italy., Oncological Medical and Specialists Department, Oncology Unit, University Hospital of Ferrara, Ferrara, Italy., Nuclear Medicine Unit, Department of Medicine, DIMED University of Padua, Padua, Italy., Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy.

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