alexa Influence of trigger PSA and PSA kinetics on 11C-Choline PET CT detection rate in patients with biochemical relapse after radical prostatectomy.
Oncology

Oncology

Journal of Nuclear Medicine & Radiation Therapy

Author(s): Castellucci P, Fuccio C, Nanni C, Santi I, Rizzello A,

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Abstract The purpose of this study was to investigate the effect of total prostate-specific antigen (PSA) at the time of (11)C-choline PET/CT (trigger PSA), PSA velocity (PSAvel), and PSA doubling time (PSAdt) on (11)C-choline PET/CT detection rate in patients treated with radical prostatectomy for prostate cancer, who showed biochemical failure during follow-up. METHODS: A total of 190 patients treated with radical prostatectomy for prostate cancer who showed an increase in PSA (mean, 4.2; median, 2.1; range, 0.2-25.4 ng/mL) were retrospectively enrolled. All patients were studied with (11)C-choline PET/CT. Patients were grouped according to trigger PSA (PSA 5 ng/mL). In 106 patients, data were available for calculation of PSAvel and PSAdt. Logistic regression analysis was used to determine whether there was a relationship between PSA levels and PSA kinetics and the rate of detection of relapse using PET. RESULTS: (11)C-choline PET/CT detected disease relapse in 74 of 190 patients (38.9\%). The detection rate of (11)C-choline PET/CT was 19\%, 25\%, 41\%, and 67\% in the 4 subgroups-PSA 5 ng/mL (49 patients)-respectively. Trigger PSA values were statistically different between PET-positive patients (median PSA, 4.0 ng/mL) and PET-negative patients (median PSA, 1.4 ng/mL) (P = 0.0001). Receiver-operating-characteristic analysis showed an optimal cutoff point for trigger PSA of 2.43 ng/mL (area under the curve, 0.76). In 106 patients, PSAdt and PSAvel values were statistically different between patients with PET-positive and -negative scan findings (P = 0.04 and P = 0.03). The (11)C-choline PET/CT detection rate was 12\%, 34\%, 42\%, and 70\%, respectively, in patients with PSAvel < 1 ng/mL/y (33 patients), 1 < PSAvel 5 ng/mL/y (28 patients). The (11)C-choline PET/CT detection rate was 20\%, 40\%, 48\%, and 60\%, respectively, in patients with PSAdt > 6 mo (45 patients), 4 < PSAdt
  • DOI: 10.2967/jnumed.108.061507
  • This article was published in J Nucl Med and referenced in Journal of Nuclear Medicine & Radiation Therapy

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