18-F CHOLINE PET CT IN PRIMARY DIAGNOSIS OF THE PROSTATE CANCER

Česká verzia

Authors: Šárka Kudláčková ¹; Milan Král ¹; Pavel Koranda ²; Vladimír Študent ¹
Authors place of work: Urologická klinika Fakultní nemocnice Olomouc ¹; Klinika nukleární medicíny Fakultní nemocnice Olomouc ²
Published in the journal: Ces Urol 2016; 20(1): 57-64
Category: Originální práce

Summary

Aim:
The aim of the study was to determine the benefits of 18F-fluorocholine PET/CT in patients with repeated negative biopsies and continued suspicion of prostate carcinoma.

Material and methods:
18F-fluorocholine PET/CT (18F-FCH PET/CT) was performed with 30 patients from January 2013 until May 2015. Indication criteria were PSA above 10 ng/ml and three biopsies. If possible patients underwent six weeks treatment of antibiotic therapy with Doxycyclin 100mg twice per day to eliminate inflammation and possible false findings in PET/CT. Then PET/CT was performed with following targeted biopsy of focus from 18F-FCH PET/CT. Targeted biopsy was done under the sonographic transrectal control with the help of cognitive fusion PET/CT image with real-time sonography. Only samples from centers identified with PET/CT were taken.

Results:
From January 2013 until May 2015 30 patients underwent 18F-FCH PET/CT. Average age of patients was 66 years (57–75 years). We confirmed prostate cancer in 14 of them which is 46 % success in rebiopsy group. All these patients had Gleason score above seven and PSA higher than 20 ng/ml.

Conclusions:
We have shown in our sample the benefits of 18F-cholinFCH PET/CT in patients with repeated negative biopsies and continued PSA elevation, where prostate carcinoma was not detected in standard biopsies. The use of 18F-FCH PET/CT seems promising in diagnostic of prostate cancer where 18F-fluorocholine can be found also in slow growing cells of majority of prostate carcinoma. Using this method we can diagnose also tumors, which are located outside of typical areas in the peripheral zone and therefore can be missed even in repeated biopsies.

KEY WORDS:
Prostate carcinoma, rebiopsy, 18F-fluorocholine PET/CT.

Zdroje

1. SVOD. www.svod.cz

2. Chen ME, Johnston DA, Tang K, Babaian RJ, Troncoso P. Detailed mapping of prostate carcinoma foci: biopsy strategy implications. Cancer 2000; 89: 1800–1809.

3. Djavan B, Zlotta A, Kratzik C. PSA, PSA density, PSA density of transitional zone, free/total PSA ratio and PSA velocity for early detection of prostate cancer in men with serum PSA 2,5-to 4 ng/ml. Urology 1999; 54: 517–522.

4. Campos-Fernandes JL, Bastien L, Nicolaiew N, et al. Prostate cancer detection rate in patients with repeated extended 21-sample needle biopsy. Eur Urol 2009; 55: 600–606.

5. Ferda J, Hora M, Hes O, et al. Zobrazení prostaty na 3T MRI u nemocných se zvýšenou hladinou PSA. Ces Radiol 2012; 66(1): 9–17.

6. Dolejšová O, Eret V, Šobrová A, et al. Využití multiparametrické magnetické rezonance a srovnání s ostatními moderními zobrazovacími metodami v předoperační diagnostice karcinomu prostaty. Ces Urol 2014; 18(4): 300–309.

7. Wetter A, Lipponer Ch, Nensa F, et al. Evaluation of the PET component of simultaneous 18F-choline PET/MRI in prostate cancer: comparison with 18F-choline PET/CT. Eur J Nucl Med Mol Imaging 2014; 41: 79–88.

8. Ferdová E, Ferda J, Baxa J, et al. PET/CT s 18F-fluorocholinem u karcinomu prostaty, dvouleté zkušenosti. Ces Radiol 2014; 68(1): 22–29.

9. Sanz G, Robles JE, Gimnez M, et al. Positron emission tomography with 18fluorine-labelled deoxyglucose: utility in localized and advanced prostate cancer. BJU Int 1999; 84: 1028–1031.

10. Ackerstaff E, Glunde K, Bhujwalla ZM. Choline phospholipid metabolism: a target in cancer cells? J Cell Biochem 2003; 90(3): 525–533.

11. Hara T, Kosaka N, Kishi H. PET imaging of prostate cancer using carbon-11-choline. J Nucl Med 1998; 39: 990–995.

12. DeGrado TR, Baldwin SW, Wang S, et al. Synthesis and evaluation of (18)F-labeled choline analogs as oncologic PET tracers. J Nucl Med 2001; 42: 1805–1814.

13. Mertens K, Ham H, Deblaere K, et al. Distribution patterns of 18F-labelled fluoromethylcholine in normal structures and tumors of the head: a PET/MRI evaluation. Clin Nucl Med 2010; 37: 196–203.

14. Chondrogiannis S, Marzola MC, Grassetto G, et al. New acquisition protocol of 18F-choline PET/CT in prostate cancer patients: review of the literature about methodology and proposal of standardization. BioMed Research International, 2014, article ID 215650, 10 pages.

15. Schillaci O, Calabria F, Tavolozza M, et al. 18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer. Nucl Med Commun 2010; 31(1): 39–45.

16. Husarik DB, Miralbell R, Dubs M, et al. Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 2008; 35: 253–263.

17. Igerc I, Kohlfurst S, Gallowitsch HJ, et al. The value of 18F-choline PET/CT in patients with elevated PSA-level and negative prostate needle biopsy for localisation of prostate cancer. Eur J Nucl Med Mol Imaging 2008; 35: 976–983.

18. Kwee SA, Coel MN, Lim J, Ko JP. Prostate cancer localization with 18fluorine fluorocholine positron emission tomography. J Urol 2005; 173: 252–255.

19. Kwee SA, Thibault GP, Stack RS, et al. Use of step-section histopathology to evaluate 18F-fluorocholine PET sextant localization of prostate cancer. Mol Imaging 2008; 7: 12–20.

20. Lee AG, Choi Yh, Cho SY, Cho IR. A prospective study of reducing unnecessary prostate bipsy in patiens with high serum prostate-specific antigen with consideration of prostatic inflammation. Korean J Urol 2012; 53: 50–53.

21. Djavan B, Ravery V, Zlotta A, et al. Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: when should we stop? J Urol 2001; 166: 1679–1783.

22. Bott SRJ, Young MPA, Kellett MJ, Parkinson MC. Anterior prostate cancer: is it more difficult to diagnose? BJU Int 2002; 89: 886–889.

23. Bouyé S, Potiron E, Puech P, Leroy X, Lemaitre L, Villers A. Transition zone and anterior stromal prostate cancers: Zone of origins and intraprostatic patterns of spread at histopatology. The Prostate 2009; 69: 105–113.

24. Röthke M, Blondin D, Schlemmer HP, Franiel T. PI-RADS classification: structured reporting for MRI of the prostate. Fortschr Röntgenstr 2013; 185 (3): 253–261.

25. Dickinson L, Ahmed HU, Allen C, et al. Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from aEuropean consensus meeting. Eur Urol 2011; 4: 477–494.

26. Šobrová E, Eret V, Dolejšová O, et al. Komparace multiparametrické magnetické rezonance se silou magnetického pole 3 Tesla s transrektální sonografií naváděnou biopsií prostaty. Ces Urol 2014; 18(3): 225–233.

27. Namimoto T, Morishita S, Saitoh R, et al. The value of dynamic MR imaging for hypointensity lesions of the peripheral zone of the prostate. Comput Med Imaging Graph 1998; 22(3): 239–245.

28. Schwarzenböck S, Souvatzouglou M, Krause BJ. Choline PET and PET/CT in primary diagnosis and paging of prostate cancer. Theranostics 2012; 2(3): 318–330.

29. Eiber M, Maurer T, Souvatzoglou M, et al. Evaluation of Hybrid 68Ga-PSMA-Ligand PET/CT in 248 Patients with Biochemical Recurrence after Radical Prostatectomy. J Nucl Med 2015; 56: 668–674.