Nuclear Medicine Unit, Department of Haematology Oncology and Laboratory Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy.
Clin Nucl Med. 2013 Jul;38(7):e279-82. doi: 10.1097/RLU.0b013e3182952c4c.
The purpose of this preliminary study was to evaluate the usefulness of 11C-choline PET/CT in patients with recurrent prostate cancer and hormone-sensitive disease treated with intermittent antiandrogen therapy scheme.
We retrospectively evaluated 10 patients after radical prostatectomy (n = 8) or external beam radiotherapy (n = 2) as primary therapy, studied with sequential 11C-choline PET/CT. The first PET/CT (PET1) was performed during antiandrogen therapy (ADT) and the second PET/CT (PET2) was performed after therapy interruption. Only patients with negative results at PET1 were included in the study. At the time of PET1, all patients were under ADT from at least 6 months (mean PSA 0.54 ng/mL). At the time of PET2, all patients had completed ADT for a mean period of 7 months. 11C-Choline PET/CT findings were validated by a follow-up of at least 12 months or histological confirmation in case of local relapse.
PET2 has been able to detect the site of recurrences in all cases. At the time of PET2, mean PSA was 3.88 ng/mL; mean PSAdt was 2.46 months; and mean PSAvel was 6.94 ng/mL/year. Four out of 10 patients showed a single lesion, 5 out of 10 patients showed 2 lesions and 1 patient showed multiple lymph-node lesions.
When performed during ADT interruption, 11C-choline PET/CT has been able to detect the site of recurrence in patients with increasing PSA values. In this context, 11C-choline PET/CT may help to assess the burden of disease or to change the therapeutic approach using more aggressive and addressed therapies like guided RT or salvage lymph-node dissection.
本初步研究旨在评估 11C-胆碱 PET/CT 在接受间歇性抗雄激素治疗方案治疗的复发性前列腺癌和激素敏感疾病患者中的应用价值。
我们回顾性评估了 10 例患者，这些患者均接受了根治性前列腺切除术（n=8）或外照射放疗（n=2）作为初始治疗，并进行了连续 11C-胆碱 PET/CT 检查。第一次 PET/CT（PET1）在抗雄激素治疗（ADT）期间进行，第二次 PET/CT（PET2）在治疗中断后进行。仅纳入 PET1 结果为阴性的患者进行研究。在 PET1 时，所有患者均接受 ADT 治疗至少 6 个月（平均 PSA 为 0.54ng/mL）。在 PET2 时，所有患者均已完成 ADT 治疗，平均时间为 7 个月。11C-胆碱 PET/CT 检查结果通过至少 12 个月的随访或局部复发时的组织学确认进行验证。
PET2 能够在所有病例中检测到复发部位。在 PET2 时，平均 PSA 为 3.88ng/mL；平均 PSAdt 为 2.46 个月；平均 PSAvel 为 6.94ng/mL/年。10 例患者中有 4 例显示单个病灶，5 例显示 2 个病灶，1 例显示多个淋巴结病灶。
在 ADT 中断期间进行时，11C-胆碱 PET/CT 能够在 PSA 值升高的患者中检测到复发部位。在这种情况下，11C-胆碱 PET/CT 可能有助于评估疾病负担，或通过使用更积极和针对性的治疗方法（如引导性放疗或挽救性淋巴结清扫术）来改变治疗方法。
