Operational characteristics of 11C-choline positron emission tomography/computerized tomography for prostate cancer with biochemical recurrence after initial treatment

Christopher R. Mitchell, Val J. Lowe, Laureano J. Rangel, Joseph C. Hung, Eugene D. Kwon, R. Jeffrey Karnes

Research output: Contribution to journalArticlepeer-review

78 Scopus citations

Abstract

Purpose: We examined the performance of 11C-choline positron emission tomography/computerized tomography for its ability to delineate prostate cancer distribution and extent after initial therapy. Materials and Methods: A consecutive series retrospective review was performed of all patients with prostate cancer who were evaluated using 11C-choline positron emission tomography/computerized tomography from September 2007 to November 2010 at the Mayo Clinic. Statistical analysis was performed to determine the sensitivity, specificity, positive predictive value, negative predictive value and prostate specific antigen threshold for the detection of recurrent lesions. Results: In the study period 176 patients with biochemical recurrence after primary treatment failure underwent 11C-choline positron emission tomography/computerized tomography. Using patient based analysis 11C-choline positron emission tomography yielded a sensitivity, specificity, positive predictive value and negative predictive value of 93%, 76%, 91% and 81%, respectively. Of the 176 positron emission tomography/computerized tomography scans performed 56 (32%) were deemed clinically useful as defined by the ability to identify lesions not delineated using conventional imaging, thereby prompting changes in clinical management. The optimal prostate specific antigen for lesion detection was 2.0 ng/ml. On multivariate analysis prostate specific antigen at positron emission tomography (HR 1.37, p = 0.04) and clinical stage at initial diagnosis of prostate cancer (HR 5.19, p = 0.0035) were significant predictors of positive 11C-choline positron emission tomography/computerized tomography. Conclusions: 11C-choline positron emission tomography/computerized tomography performs well in men with biochemical recurrence after primary treatment failure. The optimal prostate specific antigen value for lesion detection is approximately 2.0 ng/ml. We found that 11C-choline positron emission tomography/computerized tomography substantially enhances the rate of prostate cancer lesion detection by approximately 32% beyond what can be garnered using conventional imaging techniques and at a lower prostate specific antigen value.

Original languageEnglish (US)
Pages (from-to)1308-1313
Number of pages6
JournalJournal of Urology
Volume189
Issue number4
DOIs
StatePublished - Apr 1 2013

Keywords

  • choline
  • positron-emission tomography and computed tomography
  • prostatic neoplasms
  • recurrence

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Operational characteristics of <sup>11</sup>C-choline positron emission tomography/computerized tomography for prostate cancer with biochemical recurrence after initial treatment'. Together they form a unique fingerprint.

Cite this