Prostate cancer is one of the most relevant tumors in male. After radical
treatment for this tumor an increase of PSA serum level indicates a
recurrence of disease. Once recurrence is suspected re-staging procedures
are indicated, involving different studies such as trans-rectal
ultrasound, CT, MR imaging and bone scintigraphy.
PET with [18F]FDG is showing increasing usefulness in clinical oncology.
However, its use in some tumors, including prostate adenocarcinoma, is
limited by a low sensitivity. Recently, methyl-11C-Choline ([11C]Choline)
has been introduced as a new positron emitting tracer for PET whole body
studies in tumors.
The present study was aimed to compare the value of [11C]Choline-PET with
both [18F]FDG-PET and conventional diagnostic imaging techniques in re-
staging prostate adenocarcinoma in a large group of 100 patients. The
results demonstrated that [11C]Choline-PET seems to be an useful technique
to re-stage prostatectomized patients with increasing serum PSA levels. It
is superior to [18F]FDG-PET and complementary to conventional imaging
techniques, but with the advantage of staging the disease in one single
step. In addition, a new imaging technique combining state of the art PET
and CT equipments (PET/CT) has been recently introduced in clinical use.
By combining morphological and functional information, [11C]Choline-PET/CT
could be the first step examination in re-staging prostatectomized
patients with the evidence of PSA rising.
Research field:
Such a study is included in oncologic researches, with the precise aim of
developing new PET tracer to be used in tumors.
Clinical applications:
[11C]Coline-PET seems to be an useful technique to re-stage
prostatectomized patients with increasing serum PSA levels. It is
complementary to conventional imaging techniques, but with the advantage
of staging the disease in one single step. The validation of this
technique may thus change the conventional clinical management of these
patients, with advantages in terms of prompt and proper therapeutic
intervention and positive economic consequences.
Collaborations:
The evaluation of [11C]Choline uptake in tumors permit to create a tight
connection with clinical oncologist, but also with molecular biologists
when tumor samples are collected and analysed in comparison with [11C]
Choline uptake in tumors.
Future developments
In the future we propose to evaluate the mechanism of [11C]Choline uptake
in tumors by comparing PET in vivo data with histological and molecular
biology parameters and to extend its application to the evaluation of
tumors less sensitive to [18F]FDG, including initial staging of prostate
cancer and diagnosis of low grade gliomas and of bronchioalveolar
carcinoma (BAC). The results of this research have recently been published
in the Journal of Urology.
Focus