Value of [11C]choline-positron emission tomography for re-staging prostate cancer:: A comparison with [18F]fluorodeoxyglucose-positron emission tomography

Purpose: We compared [C-11]choline-positron emission tomography (PET) with [F-18]fluorodeoxyglucose-PET for re-staging prostate cancer in a group of 100 patients. Materials and Methods: A total of 100 consecutive patients referred for whole body [Flfluorodeoxyglucose-PET for clinical prostate re-staging after radical treatment for prostate cancer were retrospectively included in the study. Mean prostate specific antigen (PSA) was 6.57 ng./ml. In all cases [C-11]choline-PET was also performed. PET studies were done with a multiring device 5 minutes after intravenous injection of approximately 370 MBq. [C-11]choline and 60 minutes after injection of approximately 370 MBq. [F-18]fluorodeoxyglucose. PET findings were compared with those obtained with different conventional imaging and with PSA assessed at the time of PET and 1 year later. Results: Areas of abnormal focal increases were noted in 47% of patients on [C-11]choline-PET and in 27% on [F-18]fluorodeoxyglucose-PET. Of the 100 patients 49 had positive conventional imaging findings. All except 14 [C-11]choline-PET findings were concordant with conventional imaging, including 6 negative and 8 positive conventional imaging results. All except 1 [C-11]choline-PET negative cases also had negative conventional imaging after 1 year. PSA at 1 year remained stable or decreased in 80% and 62% of [C-11]choline-PET negative and positive cases, respectively. Conclusions: [C-11]choline-PET seems to be useful for re-staging prostatectomy cases with increasing serum PSA levels. It is superior to [F-18]fluorodeoxyglucose-PET and complementary to conventional imaging but with the advantage of staging disease at a single step.