Prognostic value of metabolic parameters and clinical impact of (18)F-fluorocholine PET/CT in biochemical recurrent prostate cancer.

To evaluate the therapeutic impact of (18)F-fluorocholine (FCH) PET/CT in biochemical recurrent prostate cancer (PC) and to investigate the value of quantitative FCH PET/CT parameters in predicting progression-free survival (PFS).

This retrospective study included 172 consecutive patients with PC who underwent FCH PET/CT for biochemical recurrence Mean rising PSA was 10 7 ± 35 0 ng/ml Patients with positive FCH PET were classified into three groups: those with uptake only in the prostatic bed, those with locoregional disease, and those with distant metastases Referring physicians were asked to indicate the hypothetical therapeutic strategy with and without the FCH PET/CT results Clinical variables and PET parameters including SUVmax, SUVpeak, SUVmean, total lesion choline kinase activity (TLCKA) and standardized added metabolic activity (SAM) were recorded and a multivariate analysis was performed to determine the factors independently predicting PFS

In 137 of the 172 patients, the FCH PET/CT scan was positive, and of these, 29 9 % (41/137) had prostatic recurrence, 42 3 % (58/137) had pelvic lymph node recurrence with or without prostatic recurrence, and 27 7 % (38/137) had distant metastases The FCH PET/CT result led to a change in treatment plan in 43 6 % (75/172) of the 172 patients Treatment was changed in 49 6 % (68/137) of those with a positive FCH PET/CT scan and in 20 % (7/35) of those with a negative FCH PET/CT scan After a median follow-up of 29 3 months (95 % CI 18 9 - 45 9 months), according to multivariate analysis age

This study indicates that a positive FCH PET result in PC patients with biochemical recurrence predicts a shorter PFS and confirms the major impact of the FCH PET result on the management of biochemical recurrent PC

European journal of nuclear medicine and molecular imaging 2015 Jul 21 [Epub ahead of print]

M Colombié, L Campion, C Bailly, D Rusu, T Rousseau, C Mathieu, L Ferrer, N Rousseau, F Kraeber-Bodéré, C Rousseau

Nuclear Medicine, Institut de Cancérologie de l'Ouest René Gauducheau, Boulevard Jacques Monod, 44805 Nantes-St Herblain Cedex, France