Imaging primary prostate cancer with 11C-Choline PET/CT: Relation to tumour stage, Gleason score and biomarkers of biologic aggressiveness - Abstract

BACKGROUND: As a significant overlap of 11C-Choline standardized uptake value (SUV) between prostate cancer and benign prostate hyperplasia (BPH) tissue, controversy exists regarding the clinical value of 11C-Choline PET/CT scan in primary prostate cancer.

In this study, the SUVmax of the prostate lesions and the pelvic muscles were measured and their ratios (SUVmax-P/M ratio) were calculated. Then we evaluated whether the tracer 11C-Choline uptake, quantified as SUVmax-P/M ratio, correlated with tumour stage, Gleason score, and expression levels of several biomarkers of aggressiveness.

METHODS: Twenty-six patients with primary prostate cancer underwent 11C-Choline PET/CT. Tumour specimens from these patients were graded histopathologically, and immunnohistochemistry for Ki-67, CD31, androgen receptor (AR), Her-2/neu, Bcl-2, and PTEN were performed.

RESULTS: Both SUVmax and SUVmax-P/M ratio showed no significant difference between patients with tumour stage II and III, but significantly elevated in patients with tumour stage IV. SUVmax-P/M ratio was also significantly higher in lesions with Gleason score of 4+3 or higher versus less than or equal to 3+4. SUVmax-P/M ratio was found significantly correlated with expression levels of Ki-67 and CD31. In addition, a higher SUVmax-P/M ratio was demonstrated in Her-2/neu positive subgroup than negative subgroup. At the same time, Gleason score and expression levels of these biomarkers showed no significant association with SUVmax.

CONCLUSIONS: Using the parameter SUVmax-P/M ratio, 11C-Choline PET/CT may be a valuable non-invasive imaging technology in the diagnosis of primary prostate cancer.

Written by:
Chen J, Zhao Y, Li X, Sun P, Wang M, Wang R, Jin X.   Are you the author?
Department of Minimally Invasive Urology center, Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China.

Reference: Radiol Oncol. 2012 Sep;46(3):179-88.
doi: 10.2478/v10019-012-0034-y

PubMed Abstract
PMID: 23077456 Prostate Cancer Section