Diagnostic utility and therapeutic impact of PET/CT [18F]F-Fluoromethylcholine-Choline in the biochemical recurrence of prostate cancer

Objective: To assess the diagnostic capability of PET/CT with [F-18]F-Fluoromethylcholine in prostate cancer (PC) with biochemical recurrence and its therapeutic impact. Material and methods: We included 108 patients, diagnosed with PC with biochemical criteria for recurrence. A PET/CT Choline scan was performed by dynamic pelvic and whole body study at 60min post-tracer injection. The relationship between the positive studies and the PSA value was analysed by classifying patients into three groups (<1.2/1.2-2> 2 ng/ml), and the diagnostic capacity was assessed with respect to pelvic MRI and the impact on the therapeutic decision. Results: The location of recurrence was identified in 85 of 108 patients (78.7%): 34 local, 47 pelvic lymph nodes and 58 distant lesions, including retroperitoneal, mediastinal lymph nodes and distant organ lesions (bone and lung). Second tumors were diagnosed in 4 patients. No significant differences were found in the percentage of positive studies depending on primary treatment. Patients with PSA> 2 ng/ml showed a higher percentage of disease detection than patients with a lower PSA level, with significant differences (p <0.0001). PET/CT [(18)]F-Choline was able to detect local disease, not previously known from MRI, in 29.41% of patients. PET/CT Choline had an impact on therapeutic management in 67 of 108 patients (62%). Conclusions: PET/CT with [(18)]F-Fluoromethylcholine is a useful tool in the detection of locoregional and disseminated disease of PC treated with suspicion of recurrence, providing a change in therapeutic management in 62% of patients. (C) 2020 Sociedad Espanola de Medicina Nuclear e Imagen Molecular. Published by Elsevier Espana, S.L.U. All rights reserved.