Diagnostische Wertigkeit der Cholin-PET / CT bei Patienten mit Prostatakarzinom

Abstract

The choline-positron emissiontomography / computed tomography (choline-PET / CT) is a widely used imaging method for prostate cancer. This review concentrates on the relevance of choline-PET / CT for primary diagnosis, staging and re-staging of prostate cancer and highlights possible -applications in clinical practice. Therefore, we performed a systematic literature research via Pubmed and Medline database for original articles, reviews and editorials on choline-PET / CT and prostate cancer. Choline-PET / CT should not be routinely used for primary diagnosis of prostate cancer due to a lack of data. With regard to the definition of the local tumour extent (T-stag-ing) choline-PET / CT plays only a minor role, in contrast, for the evaluation of lymph node involvement it has a high positive predictive value and is equal to conventional scintigraphy in detecting bone metastases. Moreover, in cases of biochemical relapse following local therapy, choline-PET / CT seems to be appropriate for differentiating between local recurrence and systemic prostate cancer metastasis, particularly when patients are selected by defined criteria (PSA value > 1.0 ng / mL and / or PSAdt < 6 months and / or Gleason score > 7 and / or primary radiotherapy). The non-critical routine use of choline-PET / CT for patients with prostate cancer cannot be recommended, and this not only because of its high costs. It should be applied to definite clinical questions after thorough selection of appropriate patients.