Can we avoid radiotherapy with 18FCH PET/CT?

Abstract

282 Background: The aim of this study was to assess the utility of 18 fluorocholine (FCH) positron emission tomography (PET)/computed tomography (CT) in detecting local recurrence in patients with prostate carcinoma treated with radical prostatectomy surgery. Methods: 432 patients with prostate cancer were enrolled in our institution between July 2015 and August 2018. 176 were treated with radical prostatectomy surgery and presented elevated levels of PSA (0.02-1600 ng/ml). All of them underwent “Dual phase” PET-CT consisting of initial pelvis starting 20 minutes after the injection of 18 F-Choline followed by 1 hour delayed PET of the whole body. 18 F-Colina PET/TC findings were compared with other imaging techniques and/or clinical monitoring. Patients were divided in three subgroups according to PSA levels: <1 ng/ml; ≥1-5ng/ml y >5 ng/ml. Results: 39 (22%) patients had PSA levels <1 ng/ml; 90 (51%) had between 1-5 ng/ml and 47 (27%) >5 ng/ml. 120 (68%) patients showed radiotracer uptake, on the other hand, 56 (32%) patients had negative PET-CT. 153 lesions showed increased uptake on FCH-PET, only 36 (23%) of them were interpretated as local recurrence the rest of them were interpretated as extraprostatic involment (table). Conclusions: 18 FCH PET/CT has clinical implications in patients with prostate carcinoma treated with radical prostatectomy surgery not only because it avoids unnecessary radiotherapy in the surgical wound, but also, it has the ability to detect local recurrent disease and lymphatic/haematogenous involvement. [Table: see text]