11C-Choline PET/CT Identifies Osteoblastic and Osteolytic Lesions in Patients with Metastatic Prostate Cancer. (May 2015)

• Record Type: Journal Article
• Authors: Ceci, Francesco; Castellucci, Paolo; Graziani, Tiziano; Schiavina, Riccardo; Chondrogiannis, Sotirios; Bonfiglioli, Rachele; Costa, Stefano; Virgolini, Irene J.; Rubello, Domenico; Fanti, Stefano; Colletti, Patrick M.
• Is Part Of: Clinical nuclear medicine. Volume 40:Number 5(2015)
• Publication Date: 2015-05
• Subjects: 11C-choline PET/CT -- recurrent prostate cancer -- osteolytic bone lesions -- osteoblastic bone lesions -- bone metastasis; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000000783
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Aim: The aim of this study was to compare 11 C-choline PET/CT, prostate-specific antigen (PSA), PSA kinetics, and 11 C-choline uptake in recurrent metastatic prostate cancer patients with osteoblastic and osteolytic bone metastases. Patients and Methods: We retrospectively analyzed 140 patients with the following criteria: ( a ) positive bone lesions identified with 11 C-choline PET/CT and validated as true positive by histology (14.2%), correlative imaging (33.4%), or clinical follow-up (52.4%); (b) after radical prostatectomy (67.9%) or primary radiotherapy (22.1%); ( c ) proven biochemical relapse with rising PSA levels; ( d ) no chemotherapy, zoledronic acid, or palliative bone external beam radiation therapy previously administrated during biochemical relapse; and ( f ) asymptomatic for bone pain. Lesions were categorized as osteoblastic, osteolytic, or bone marrow lesions. Patients were divided into osteoblastic and osteolytic patient groups. Results: 11 C-Choline PET/CT detected oligometastatic bone disease (1–3 lesions) in 98 (70%) of the 140 patients and multiple bone lesions in 42 (30%) of the 140 patients. By per-lesion analysis of 304 lesions, there were 184 osteoblastic, 99 osteolytic, and 21 bone marrow lesions. By per-patient analysis, 97 (69.3%) of the 140 patients were in the osteoblastic group, whereas 43 (30.7%) of the 140 patients were in the osteolytic group. Statistically significant differences in SUVmax ( P < 0.001), fast PSA doubling time ( P = 0.01), and PSA velocity ( P = 0.01) were observed between osteoblastic (lower values) and osteolytic (higher values) groups. By multivariate analysis, fast PSA doubling time was a significant predictor for osteolytic lesions. Conclusions: We demonstrated differences in PSA kinetics and SUVmax between osteolytic and osteoblastic lesions. 11 C-Choline PET/CT may identify patients that could benefit from early targeted therapies, depending on the type of bone lesions expressed.