MP42-06 EARLY DETECTION OF PROSTATE CANCER RECURRENCE FOLLOWING RADICAL PROSTATECTOMY: THE ROLE OF 18F-CHOLINE PET/CT

Abstract

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2014MP42-06 EARLY DETECTION OF PROSTATE CANCER RECURRENCE FOLLOWING RADICAL PROSTATECTOMY: THE ROLE OF 18F-CHOLINE PET/CT Giuseppe Simone, Giovanni Battista, Di Pierro, Carlo Ludovico Maini, Rocco Papalia, Mariaconsiglia Ferriero, Rosa Sciuto, Salvatore Guaglianone, Vincenzo Gentile, and Michele Gallucci Giuseppe SimoneGiuseppe Simone More articles by this author , Giovanni BattistaGiovanni Battista More articles by this author , Di PierroDi Pierro More articles by this author , Carlo Ludovico MainiCarlo Ludovico Maini More articles by this author , Rocco PapaliaRocco Papalia More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Rosa SciutoRosa Sciuto More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Vincenzo GentileVincenzo Gentile More articles by this author , and Michele GallucciMichele Gallucci More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1183AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The diagnostic potential of positron emission tomography (PET)/computed tomography (CT) in patients with increasing prostate-specific antigen (PSA) serum levels after radical prostatectomy (RP) is currently under debate. However, evidences supporting the use of this imaging technique in patients with PSA levels <1ng/mL are lacking. We prospectively investigated the role of 18F-Fluorocholine PET/CT in the early (PSA< 1 ng/ml) detection of tumor recurrence after RP. Methods Between March 2007 and December 2010, 146 consecutive patients with PSA levels between 0.2 and 1 ng/mL, who did not receive adjuvant treatments after RP and with negative conventional imaging were enrolled. Univariable and multivariable analyses were performed to identify independent predictors of positive PET/CT. Sensitivity, specificity, positive and negative predictive values of PET/CT, PSA serum levels before and after 18F-Fluorocholine PET/TC, PSA doubling time (PSA-DT) and PSA velocity (PSA-V) after PET-CT. Results Median trigger PSA was 0.6 ng/ml (IQR: 0.43 – 0.76). Median PSA-DT was 7.91 months (IQR: 4.42- 11.3), median PSA-V was 0.02ng/ml/month (IQR: 0.02 – 0.04). Overall, 18F-Fluorocholine PET/CT was positive in 111/146 (76%) patients, 99 of which (89.2%) on prostatic fossa, 5 (4.5%) on regional nodes, 1 on bone and 6 (5.4%) on multiple sites. (Tab.1) Sensitivity, specificity, positive and negative predictive values (NPV) and accuracy were 79.4%, 70.0%, 97.3%, 20.0% and 78.7%, respectively. At multivariable logistic regression, trigger PSA ≥0.6 (OR 3.13, 95% CI 1.55–6.31, p=0.001) and PSA-V ≥0.04 (OR 4.95, 95% CI 1.65–14.83, p=0.004) were found to be significant predictors of positive PET/CT. The low NPV remains the main limitation of PET-CT in this setting of patients. Conclusions The high accuracy in patients with PSA level <1 ng/ml supports 18F-Fluorocholine PET/CT as a valid option in the early detection of PCa recurrence after RP. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e470 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giuseppe Simone More articles by this author Giovanni Battista More articles by this author Di Pierro More articles by this author Carlo Ludovico Maini More articles by this author Rocco Papalia More articles by this author Mariaconsiglia Ferriero More articles by this author Rosa Sciuto More articles by this author Salvatore Guaglianone More articles by this author Vincenzo Gentile More articles by this author Michele Gallucci More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...