Usefulness of 18F-fluorocoline PET/CT in prostate cancer patients with biochemical recurrence: Influence of PSA kinetics and hormone therapy

Abstract

PurposeTo evaluate the capacity of 18F-fluorocholine positron emission tomography/computed tomography (FCH PET/CT) to detect biochemical recurrence of prostate cancer and to determine the correlation with PSA kinetics and influence of antiandrogen hormone therapy. Patients and methodsObservational and retrospective study, which included patients with prostate cancer and criteria for biochemical recurrence and/or resistance to castration, according to the European Association of Urology. FCH PET/CT results were classified as positive or negative, using as gold standard the pathology report, findings of other imaging test, and/or clinical follow-up results. The correlation between FCH PET/CT and PSA kinetics (PSA at the time of exploration [PSA-trigger], doubling time [PSAdt] and velocity [PSAva]) was studied and the influence of hormone therapy was analysed. ResultsThe study included 203 patients. The FCH PET/CT detection rate was 43.3%. The group of patients with FCH PET/CT positive showed more aggressive PSA kinetics (PSAdt: 7.5 months and PSAva 8.37±14.8ng/ml/year) than the FCH PET/CT negative group (PSAdt: 14.5±7.6 months and PSAva: 1.8±3.7ng/ml/year). The detection rate of FCH PET/CT in the subgroup with castration resistance was 89.1%, significantly higher than in the group with radical treatment at 29.9%, p<0.001. ConclusionsFCH PET/CT is useful to detect biochemical recurrence of prostate cancer, especially in patients who receive hormone therapy or more aggressive PSA kinetics.