11C-Cholin PET/CT zur Prädiktion des Outcomes nach lokaler Strahlentherapie des biochemischen Rezidivs des Prostatakarzinoms
Aim: [11C]Choline-PET/CT is a promising imaging approach for localizing relapsing prostate cancer. We therefore studied performance of [11C]Choline-PET/CT in patients relapsing from prostate cancer after radical prostatectomy (RP) and relationship to outcome after SRT. Method: In a prospective pilot study we examined 27 patients with [11C]Choline-PET/CT before SRT. All patients had biochemical relapse after RP and were treated with SRT. [11C]Choline-PET/CT was done following intravenous injection of 900 MBq. Results: 11 of 27 patients (subgroup 1) had at follow up of 76.5 ± 5.7 months a favorable long term response to SRT and needed no specific further prostate cancer related treatment. In contrast, biochemical progression was seen in 16 of all 27 patients (subgroup 2), qualifying them as treatment failures. Tumor stage, risk profile and PSA before SRT were not different in long term responders and failures. Three of 11 patients showed a focally increased uptake in the prostatic bed clearly indicative of local relapse and 2 of 11 patients showed only faint focal uptake in prostatic fossa of borderline significance. There was no evidence of lymph node or distant metastases in patients of subgroup 1. In subgroup 2 , [11C]Choline-PET/CT detected local relapse in 8 of 16 patients and pelvic lymph nodes in 4 of 16 patients. In 1 patient in subgroup 2, a bone metastasis was found. Conclusion: [11C]Choline-PET/CT showed in roughly 50 % of patients evidence of local relapse within the prostatic fossa. Roughly 30 % of treatment failures had evidence of locoregional nodal or distant metastatic disease outside the radiation ports possibly related to treatment failures after SRT. Kaplan-Meier analysis suggested that [11C]Choline-PET/CT positive patients do worse at follow up in terms of freedom from biochemical recurrence.
Subject HeadingsProstatakrebs [GND]
Prostatic neoplasms [MeSH]