Spektrum požadovaných vyšetrení nukleárnej medicíny pri karcinóme prostaty po registrácii 18F fluorocholínu: dvojročné sledovanie v nemocnici Tenon
Authors:
Soňa Balogová () 1,2; Virginie Huchet () 1; Laure Michaud () 1,3; Khaldoun Kerrou () 1; Fréderique Paycha () 1; Valérie Nataf () 3,4; Marika Vereb () 5,6; Lucia Kaliská () 7; Françoise Montravers () 1,3; J.-N. Talbot () 1,3
Authors‘ workplace:
Médecine nucléaire, Hôpital Tenon, AP–HP, Paris, Francúzsko
1; Klinika nukleárnej medicíny LF UK a OÚSA Bratislava, Slovensko
2; Université Pierre-et-Marie-Curie, Paris, Francúzsko
3; Radiopharmacie, Hôpital Tenon, AP–HP, 7 020 Paris, Francúzsko
4; Klinikum Kassel Nuklearmedizin, Kassel, Nemecko
5; Oddelenie nukleárnej medicíny, Reimanus s. r. o., Prešov, Slovensko
6; INMM Košice & Agel diagnostics s. r. o., Pracovisko Banská Bystrica, Slovensko
7
Published in:
NuklMed 2012;1:42-47
Category:
Original Article
Overview
Introduction:
The registration of a new PET radiopharmaceutical by medicines agencies is infrequent and it seemed interesting to follow its consequences on the prescription of alternative nuclear medicine (NM) examinations by the referring physicians. F-18 fluorocholine (FCH) was registered in France for localisation of bone metastases of prostate cancer (PC) on April 2nd 2010.
Methods:
A survey of the prescription of NM examinations in patients with PC was performed at hospital Tenon, covering 8 quarters since the registration of FCH. We provided bone scan, PET/CT with F-18-FDG (FDG), PET/CT with F-18-FNa (FNa) and PET/CT with FCH.
Results:
During that period of time, 721 NM examinations were performed in PC patients. Demand for FCH PET/CT grew rapidly, from 11 % of the NM examinations during the 1stquarter to 37 % during the 2nd quarter and 56 % during the 8th quarter. The total number of NM examinations requested for PC also grew over that period. Overall, the share of FCH PET/CT was 42 %, 27 % for bone PET/CT with fluoride FNa, 25 % for bone scintigraphy (BS). FDG PET/CT remained limited to few cases of castrate-resistant or metastatic PC (6 % of NM examinations). Examinations limited to the detection of bone metastases (FNa and BS) were predominantly demanded for initial staging while FCH was more frequently requested in case of occult recurrence, at lower PSA serum levels. Therapy monitoring and follow-up appeared to be promising settings requiring assessment; 19 % of NM examinations were prescribed in this context, same proportion as restaging prior to treatment resuming.
Conclusion:
The introduction of FCH resulted in a rapid demand for this PET/CT examination, in particular in case of occult recurrence, with an overall increase in PC referred to NM imaging.
Key Words:
prostate cancer, fluorocholine (FCH), fluoride (FNA), fluorodeoxyglucose (FDG), bone scintigraphy (BS), medical imaging prescription
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