Effectiveness of 11C-choline PET/CT in prostate cancer surveillance

Aim: Our aim was to analyse the performance of 11C-choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/ml. Material and methods: Three hundred and twenty-nine 11C-choline PET/CT examinations from 191 patients (68.2 +/- 7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospec-tively evaluated (PSA at study was 13.0 +/- 84.2 ng/ml). Main initial treatment was radical prostatectomy in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20 min after injection of 555-740 MBq of 11C-choline. Minimum follow-up was 12 months. Results: Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The per-centage of positive examinations was significantly higher in patients with other initial treatment than radical prostatectomy compared to patients with radical prostatectomy (85.6 vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 11C-choline PET/CT scans performed with PSA < 1 ng/ml, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa.Conclusions: 11C-choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA < 1 ng/ml. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment.