Diagnostic Performance of C-11-choline PET/CT and FDG PET/CT in Prostate Cancer

We compared C-11-choline and FDG PET/CT scan findings for the staging and restaging of prostate cancer. Twenty Japanese prostate cancer patients underwent C-11-choline and FDG PET/CT before (n = 5) or after (n = 15) treatment. Using a five-point scale, we compared these scanning modalities regarding patient- and lesion-based diagnostic performance for local recurrence, untreated primary tumor, and lymph node and bony metastases. Of the 20 patients, documented local lesions, and node and bony metastases were present in 11 (55.0%), 9 (45.0%), and 13 (65.0%), respectively. The patient-based sensitivity/specificity/accuracy/area under the receiver-operating-characteristic curve (AUC) values for C-11-choline-PET/CT for diagnosing local lesions were 90.9%/100%/95.0%/1.0, whereas those for FDG-PET/CT were 45.5%/100%/75.0%/0.773. Those for C-11-choline-PET/CT for node metastasis were 88.9%/100%/95.0%/0.944, and those for FDG-PET/CT were 44.4%/100%/75.0%/0.722. Those for C-11-choline-PET/CT for bone metastasis were 84.6%/100%/90.0%/0.951, and those for FDG-PET/CT were 76.9%/100%/85.0%/0.962. The AUCs for local lesion and node metastasis differed significantly (p = 0.0039, p = 0.011, respectively). The lesion-based detection rates of C-11-choline compared to FDG PET/CT for local lesion, and node and bone metastases were 91.7% vs. 41.7%, 92.0% vs. 32.0%, and 94.8% vs. 83.0% (p = 0.041, p = 0.0030, p <0.0001), respectively. C-11-choline-PET/CT is more useful for the staging and restaging of prostate cancer than FDG-PET/CT in Japanese men.