18-F CHOLINE PET CT IN PRIMARY DIAGNOSIS OF THE PROSTATE CANCER

Czech version

Authors: Šárka Kudláčková ¹; Milan Král ¹; Pavel Koranda ²; Vladimír Študent ¹
Authors‘ workplace: Urologická klinika Fakultní nemocnice Olomouc ¹; Klinika nukleární medicíny Fakultní nemocnice Olomouc ²
Published in: Ces Urol 2016; 20(1): 57-64
Category: Original Articles

Overview

Aim:
The aim of the study was to determine the benefits of 18F-fluorocholine PET/CT in patients with repeated negative biopsies and continued suspicion of prostate carcinoma.

Material and methods:
18F-fluorocholine PET/CT (18F-FCH PET/CT) was performed with 30 patients from January 2013 until May 2015. Indication criteria were PSA above 10 ng/ml and three biopsies. If possible patients underwent six weeks treatment of antibiotic therapy with Doxycyclin 100mg twice per day to eliminate inflammation and possible false findings in PET/CT. Then PET/CT was performed with following targeted biopsy of focus from 18F-FCH PET/CT. Targeted biopsy was done under the sonographic transrectal control with the help of cognitive fusion PET/CT image with real-time sonography. Only samples from centers identified with PET/CT were taken.

Results:
From January 2013 until May 2015 30 patients underwent 18F-FCH PET/CT. Average age of patients was 66 years (57–75 years). We confirmed prostate cancer in 14 of them which is 46 % success in rebiopsy group. All these patients had Gleason score above seven and PSA higher than 20 ng/ml.

Conclusions:
We have shown in our sample the benefits of 18F-cholinFCH PET/CT in patients with repeated negative biopsies and continued PSA elevation, where prostate carcinoma was not detected in standard biopsies. The use of 18F-FCH PET/CT seems promising in diagnostic of prostate cancer where 18F-fluorocholine can be found also in slow growing cells of majority of prostate carcinoma. Using this method we can diagnose also tumors, which are located outside of typical areas in the peripheral zone and therefore can be missed even in repeated biopsies.

KEY WORDS:
Prostate carcinoma, rebiopsy, 18F-fluorocholine PET/CT.

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