Department of Nuclear Medicine, Greater Poland Cancer Center, Poznan, Poland.
Chair and Department of Nuclear Medicine, Medical University of Lublin, Lublin, Poland.
Nucl Med Rev Cent East Eur. 2022;25(1):25-30. doi: 10.5603/NMR.a2022.0006.
Aim of this study was to evaluate the rate of incidental detection of second primary cancer (SPC) at 18F-fluorocholine ([18F]FCH) positron emission tomography/computed tomography (PET/CT) performed in prostate cancer patients.
A retrospective analysis was performed on a group of 1345 prostate cancer patients, who underwent [18F]FCH PET/CT study because of suspicion of recurrence (n = 937) or for initial staging (n = 408). Images were acquired after intravenous injection [18F]FCH with a mean activity of 200 ± 75 MBq (5.4 ± 2 mCi), from the top of the head to the half of the thigh. The confirmation of second primary cancer was obtained from the cancer registry.
Based on the [18F]FCH PET/CT scans, a second primary cancer was suspected in 89 patients (6.6%). Of these, a malignancy was histologically confirmed in 26 patients (29% of all suspected findings and 1.9% of the complete cohort). Lung cancer (including adenocarcinoma, neuroendocrine cancer) was diagnosed in 13 patients (50%) and hematologic neoplasm (including chronic lymphocytic leukemia, Hodgkin lymphoma, follicular lymphoma, and multiple myeloma) in 5 patients (19%). 18F-fluorocholine PET/CT also revealed esophageal cancer, mesothelioma, testicular, renal, bladder, and colorectal cancer inindividual patients, non-keratinizing squamous cell carcinoma (SCC) of the skin as well as head and neck SCC with unknown primary.
We conclude that incidental detection of a second primary cancer in prostate cancer patients using [18F]FCH PET/CT is not very common and that lung cancer and hematologic malignancies are most frequently detected.
本研究旨在评估在前列腺癌患者中进行的 18F-氟胆碱([18F]FCH)正电子发射断层扫描/计算机断层扫描(PET/CT)时偶然发现第二原发癌(SPC)的发生率。
对 1345 例前列腺癌患者进行了回顾性分析，这些患者因怀疑复发(n=937)或初始分期(n=408)而接受[18F]FCH PET/CT 检查。静脉注射[18F]FCH 后采集图像，平均活度为 200±75MBq(5.4±2mCi)，从头顶到大腿中部。第二原发癌的确诊来自癌症登记处。
根据[18F]FCH PET/CT 扫描，89 例患者(6.6%)怀疑有第二原发癌。其中，26 例患者的恶性肿瘤得到组织学证实(占所有疑似发现的 29%，占整个队列的 1.9%)。13 例(50%)诊断为肺癌(包括腺癌、神经内分泌癌)，5 例(19%)诊断为血液系统肿瘤(包括慢性淋巴细胞白血病、霍奇金淋巴瘤、滤泡性淋巴瘤和多发性骨髓瘤)。18F-氟胆碱 PET/CT 还在个别患者中发现了食管癌、间皮瘤、睾丸癌、肾癌、膀胱癌和结直肠癌、非角化性鳞状细胞癌(SCC)以及头颈部 SCC 伴不明原发灶。
我们的结论是，在前列腺癌患者中使用[18F]FCH PET/CT 偶然发现第二原发癌并不常见，最常发现的是肺癌和血液系统恶性肿瘤。
