Significance of 18F-fluorocholine PET/CT positive pulmonary lesions in prostate cancer patients

To assess the frequency and the significance of incidental pulmonary lesions with 18F-fluorocholine (18F-FCH) PET/CT in prostate cancer (PCa) patients.

225 consecutive PCa patients referred for 18F-FCH PET/CT (median age 68 years) were retrospectively evaluated for the presence of lesions in the lungs: 173 referred for restaging and 52 for initial staging regarding their high risk of extra prostatic extension.

The final diagnosis was based on histopathological or on clinical and radiological follow-up.

13 patients had 18F-FCH positive pulmonary and 8 patients malignant lesions: 5 patients (38%) had a primary lung cancer (2 squamous cell carcinomas, 1 papillary adenocarcinoma, 1 typical pulmonary carcinoid, 1 bronchioloalveolar carcinoma) and 3 patients (23%) PCa metastases. Benign lesions were found in 5 subjects (38%). SUVmax and maximum diameter were neither significantly different in primary and metastatic tumors nor between malignant and benign lesions.

Although our results suggest that incidental uptake in the lungs in PCa patients are nonspecific, their detection may have a significant impact on patient management knowing that more than 60% represent malignant disease.

Nuklearmedizin. Nuclear medicine. 2015 Jul 27 [Epub ahead of print]

O Rager, A Baskin, G Amzalag, F Buchegger, R Miralbell, O Ratib, T Zilli, V Garibotto

Dr. Olivier Rager, Nuclear Medicine Department, Faculty of Medecine, University of Geneva, rue Gabrielle-Perret-Gentil, 4, 1211 Geneva, Switzerland