11C-Choline PET/CT in Recurrent Prostate Cancer: Retrospective Analysis in a Large U.S. Patient Series

Our purpose was to evaluate the performance of 11C-choline PET/CT in detecting biochemically recurrent prostate cancer (PCa) in a large non-European cohort (in the context of emerging evidence for prostate-specific membrane antigen PET in this setting) and to map patterns of PCa recurrence. Methods: We retrospectively analyzed 11C-choline PET/CT scans from 287 patients who were enrolled in an imaging protocol based on rising prostate-specific antigen (PSA) levels (mean, 3.43 ng/mL; median, 0.94 ng/mL; range, 0.15–89.91 ng/mL) and suspected recurrent PCa. A total of 187 patients had undergone primary radical prostatectomy (RP) (79/187 had secondary radiotherapy), 30 had undergone primary radiotherapy, and 70 had a persistent PSA elevation after receiving initial treatment (69 after RP, 1 after radiotherapy). The level of suspicion for recurrence on 11C-choline PET/CT was scored (0, negative; 1, equivocal; 2, positive) by 2 readers. The correlation between 11C-choline PET/CT positivity and initial treatment, Gleason score, National Comprehensive Cancer Network stage, PSA level, PSA doubling time, PSA velocity, and time between initial treatment and PET imaging was evaluated. Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria were used to map 11C-choline recurrence patterns. Results: Considering scores 1 and 2 as positives, consensus between the 2 readers deemed 66% of the 11C-choline PET/CT scans as positive. When sorted by PSA level, 45% of pati...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Source Type: research

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Conclusions: 68Ga PSMA PET/CT provides a novel imaging modality for the detection of prostate cancer recurrence and metastases at low posttreatment PSA levels, which may help in directing appropriate salvage treatments.
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
ConclusionsIntegrated [68Ga]PSMA-11 PET/MRI provides a similarly high diagnostic performance for localization of recurrent PC as PET/CT. For the detection of local recurrences [68Ga]PSMA-11 PET/MRI is superior compared with [68Ga]PSMA-11 PET/CT.
Source: Molecular Imaging and Biology - Category: Molecular Biology Source Type: research
Conclusion: Our patient, diagnosed with recurrent prostate BCC after receiving a radical prostatectomy, responded to treatment with etoposide. Radical prostatectomy and radiotherapy should remain first-line therapy; however, etoposide may be an alternative second-line therapy when other options are not available. Consensus regarding treatment plans, and the molecular mechanisms behind prostate BBC, must be elucidated.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
1247Background: While the diagnostic performance of 18F-FACBC PET/CT imaging in the restaging of patients with biochemical recurrence (BCR) after initial prostatectomy is well documented, its clinical utility in patients with BCR following primary non-prostatectomy treatments is unknown. We aimed to determine detection rate of 18F-FACBC PET/CT scan and the patterns of prostate cancer recurrence in patients with suspected BCR after initial non-prostatectomy treatments, particularly in patients with PSA levels below the accepted Phoenix definition of PSA failure (PSA nadir + 2). Methods: In this single tertiary institution s...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: GU - non-PSMA imaging (Poster Session) Source Type: research
Conclusions: [68Ga]Ga-P16-093 appears useful for pre-prostatectomy assessment of patients with intermediate- or high-risk prostate cancer to better define the regional location(s) of disease. In this initial assessment, PET-derived knowledge of regional PSMA expression would have modified surgical planning in 6 of the 10 patients. (Supported by NIH/NCI R44CA233140.)
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: GU - PSMA PET (Poster Session) Source Type: research
Conclusions: 68Ga-THP-PSMA PET/CT had a major clinical impact in patients with prostate cancer. Management plans changed in nearly one third of patients with primary untreated prostate cancer and in over half of patients with biochemical recurrence. These results are comparable with management change figures reported with other types of PSMA PET tracers. 68Ga-THP-PSMA was well tolerated. No patients experienced SAEs or discontinued the study due to AEs. These results together with the simple cold kit manufacturing process of 68Ga-THP-PSMA are promising for larger scale accessibility and serve as a basis for a multicentre p...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: GU - PSMA PET (Poster Session) Source Type: research
1268Objectives: 68Ga-PSMA-HBED-CC (68Ga-PSMA-611) PET/CT represents a clinically relevant and commonly used technique for the evaluation of prostate cancer patients in the setting of secondary staging for biochemical recurrence after definitive therapy. A novel tracer developed in our Centre: [18F]AIF-PSMA-HBED-CC (18F-ALF-PSMA-11), can be produced on a large scale with suitable radiochemical purity for clinical purposes. The aim of this study was to prospectively compare the diagnostic values of 68Ga-PSMA-611 versus 18F-ALF-PSMA-11 in patients with prostate cancer and biochemical relapse after initial treatment. A sample ...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: GU - PSMA PET (Poster Session) Source Type: research
We present a 60-year-old man with known prostate cancer treated with robot-assisted radical prostatectomy. Prostate-specific antigen levels did not decline accordingly, and a second 68Ga-PSMA PET/CT demonstrated a new focus with high 68Ga-PSMA uptake in the pancreatic tail. A subsequent CT scan did not display the lesion as a typical pancreatic tumor, and a spleen scintigraphy was also negative excluding an ectopic intrapancreatic accessory spleen. 68Ga-DOTATOC PET/CT showed uptake in the same area of the pancreatic tail consistent with a neuroendocrine tumor. This case illustrates that neuroendocrine tumors can be importa...
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
We present a case of a 79 year old patient with a medical history of unilateral nerve-sparing radical prostatectomy due to a pT3aN0 (Gleason score 7) prostate carcinoma. Because of slightly elevated prostate specific antigen (PSA) level (0.35ng/dL), a fluorine-18-prostate specific membrane antigen (18F-PSMA)-1007 positron emission tomography/computed tomography (PET/CT) scan was performed, showing no signs of malignant recurrence. However, a moderately PSMA-avid nodular lesion was observed in the left occipital region with homogeneous contrast enhancement, suggestive for a meningioma, which was confirmed on magnetic resona...
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
We present a 60-year-old man with known prostate cancer treated with robot-assisted radical prostatectomy. Prostate-specific antigen levels did not decline accordingly, and a second Ga-PSMA PET/CT demonstrated a new focus with high Ga-PSMA uptake in the pancreatic tail. A subsequent CT scan did not display the lesion as a typical pancreatic tumor, and a spleen scintigraphy was also negative excluding an ectopic intrapancreatic accessory spleen. Ga-DOTATOC PET/CT showed uptake in the same area of the pancreatic tail consistent with a neuroendocrine tumor. This case illustrates that neuroendocrine tumors can be important pit...
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Clin Nucl Med Source Type: research
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