11C Choline- PET in prostate RTInfluence of 11C-choline PET/CT on the treatment planning for salvage radiation therapy in patients with biochemical recurrence of prostate cancer
Section snippets
Patients
Thirty-seven consecutive asymptomatic patients (mean age: 63.6 ± 6.2 yr, range: 49–78), all treated primarily with radical prostatectomy for prostate cancer, referred for salvage radiation therapy because of biochemical evidence of recurrence, were retrospectively included in this study. They underwent a 11C-choline-PET/CT scan prior to radiotherapy. The period of inclusion was from January 2005 to December 2006. Inclusion criterion to perform a 11C-choline-PET/CT scan was biochemical evidence of
Results
Characteristics, imaging results and outcome of the patients are summarized in Table 2. The median time for evaluation of initial PSA response after radiotherapy was 1.7 months. The median total follow up after radiotherapy was 51.2 months (Table 1).
Discussion
Our results demonstrate an extension of the planning target volume in a considerable percentage (13%) of prostate cancer patients referred for prostatic fossa SRT because of biochemical recurrence after prostatectomy, if a 11C-choline PET/CT scan is used in the treatment planning. In particular 4/5 patients with lymph node uptake had negative surgical margins, a feature which in some studies is associated with an unfavourable response rate to prostatic fossa SRT, as the PTV, probably does not
Conclusion
11C-choline PET/CT scan leads to an extension in the planning target volume in 13% of cases, when performed in a group of patients referred for radiation therapy because of biochemical recurrence after radical prostatectomy. 75% of patients with extended PTV according to the 11C-choline PET/CT scan returned findings, were relapse free in the follow up period. Therefore, PET/CT might be useful to individualize treatment in those patients, however further prospective studies are needed to assess
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2019, European Urology OncologyCitation Excerpt :False negative results may occur in micrometastatic (tumor deposit of <2 mm) adenopathies. Unexpected metastatic deposits may be detected in lymph nodes outside the pelvis or bone in 13–21% of patients referred for evaluation of local recurrence with 11C choline PET-CT [71,85]. Imaging techniques 11C choline PET-CT and mpMRI are complementary for restaging in suspected recurrent disease, and both can be recommended for evaluation in early biochemical relapse.