Stellenwert der 11C-Cholin-PET/CT in der onkologischen Nachsorge bei Patienten mit Prostatakarzinom nach erfolgter Primärtherapie

Abstract

Results: 322 [11C]-Choline PET/CT examinations were performed after a mean period after primary therapy of 35 mos. (range: 1-720 mos.). 76% (246/322) of the hormonnaive pts. underwent [11C]-Choline PET/CT, in 24% (76/322) PET/CT was performed during antiandrogen- therapy. PET positive results are seen in 71% (229/322) at a median PSA 5.9 ng/ml (range: 0-444 ng/ml), at a mean PSA of 1.8 ng/ml (range: 0.017-16.8 ng/ml) in 29% (93/322) PET showed a negative result. Tumour manifestations are seen in PET in group A (operative intention) in 65% (135/193), in group B (pts. after brachytherapy or radiotherapy) in 80% (20/25), in group C (pts. after antiandrogen-therapy) in 81% (84/104). Multiple tumour manifestations were detected in 29% only, isolated relapse was found in 71% (163/229). Isolated local relapse was demarked in 56% (129/229; in group A 30% [58 pts.], isolated pelvine lymph nodes in 14% (34/229, in group A 16% [30 pts.], in group B 8% [2 pts.]). Only in 7% (16/229) osseous metastases were observed. Conclusion: [11C]-Choline PET/CT as a single-step exam is an accurate imaging modality to identify the location in patients with recurrent diseases. In case of rising PSA after therapy a discrimination between local and systemic progression can be taken by using [11C]-Choline PET/CT. Therefore, in patients with prostate cancer relapse after therapy with curative intention [11C]-Choline PET/CT seems to be a useful diagnostic tool to select patients suitable for salvage radiotherapy.