Department of Oncology, The University of Western Ontario, London Health Sciences Centre-St Joseph's Healthcare Centre, London, Ontario, Canada.
Prostate Cancer Prostatic Dis. 2012 Mar;15(1):45-55. doi: 10.1038/pcan.2011.35. Epub 2011 Aug 16.
Positron emission tomography (PET or combined PET-computed tomography (PET/CT)) allows the non-invasive interrogation of metabolic processes using radiolabeled probes. Altered choline metabolism has been noted as a characteristic of prostate cancer (PCa), and radiolabeled choline and choline analogs have been investigated as PET/CT imaging agents for prostate cancer; [(18)F]fluoromethyl-dimethyl-2-hydroxyethyl-ammonium ((18)F-FCH) shows particular promise as a PCa imaging agent given its favorable physical and pharmacokinetic properties.
We conducted a systematic review of results to date with (18)F-FCH. As the tracer was first described by DeGrado in 2001, we limited our search from January 2001 to August 2011.
In all, 37 studies including 1244 patients met the inclusion criteria. Studies included those detailing the radiosynthesis of (18)F-FCH, preclinical and early clinical dosimetry, and biodistribution (n=7); evaluation of local disease (n=6), nodal disease (n=5), bone metastases and castrate-resistant disease (n=7), biochemical recurrence (n=11), radiotherapy planning (n=7) and sources of false-positive studies (n=2); and some studies reported on multiple indications. Potential sources of variations in the studies affecting reported performance included case series size, variation in extent of disease at imaging (including Gleason grade, and PSA), selection of gold standards for comparison and variations in scan technique.
On the basis of the review, we suggest potential scenarios where this metabolic imaging might be considered for further evaluation in clinical trials for guiding PCa management.
正电子发射断层扫描（PET 或结合正电子发射断层扫描和计算机断层扫描的 PET/CT）允许使用放射性标记探针进行非侵入性的代谢过程检测。已注意到胆碱代谢改变是前列腺癌（PCa）的特征之一，并且放射性标记胆碱和胆碱类似物已被作为前列腺癌的 PET/CT 成像剂进行研究；[(18)F]氟甲基-二甲基-2-羟乙基-铵（[(18)F-FCH）因其良好的物理和药代动力学特性，作为 PCa 成像剂显示出特别的前景。
我们对迄今为止使用[(18)F-FCH]的结果进行了系统回顾。由于该示踪剂是由 DeGrado 于 2001 年首次描述的，我们将搜索范围限制在 2001 年 1 月至 2011 年 8 月。
共有 37 项研究，包括 1244 名患者，符合纳入标准。这些研究包括[(18)F-FCH]的放射合成、临床前和早期临床剂量学以及生物分布研究（n=7）；局部疾病评估（n=6）、淋巴结疾病评估（n=5）、骨转移和去势抵抗性疾病评估（n=7）、生化复发评估（n=11）、放疗计划评估（n=7）和假阳性研究的来源评估（n=2）；一些研究报告了多种适应症。影响报告性能的研究中潜在的变化来源包括病例系列的大小、影像学上疾病的严重程度（包括 Gleason 分级和 PSA）、比较的金标准选择以及扫描技术的变化。
根据本次综述，我们建议在临床试验中进一步评估这种代谢成像，以指导前列腺癌的管理，在某些情况下可以考虑使用这种方法。
