fluorocholine and Adenocarcinoma

Prostate cancer is the most common malignant tumour and represents the third cause of cancer-mortality in men. The management of prostate cancer has dramatically changed over the last decades, mainly due to improvement of diagnostic modalities and development of new therapeutic strategies. Imaging plays a key role in all the steps of prostate cancer management. In recent years, magnetic resonance imaging (MRI) and positron-emission tomography (PET) - computed tomography (CT) have emerged as two major tools for the detection of prostate cancer, tumour staging and treatment choice. Both MRI and PET-CT - using choline or prostate-specific membrane antigen (PSMA) as radiotracer - have become mandatory. This article presents the contribution of the latest advances in these two imaging techniques of prostate cancer and their future developments.

Topics: Adenocarcinoma; Aged; Antigens, Surface; Carbon Radioisotopes; Choline; Fluorine Radioisotopes; Glutamate Carboxypeptidase II; Humans; Magnetic Resonance Imaging; Male; Multimodal Imaging; Neoplasm Recurrence, Local; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Ultrasonography

Major improvements in the field of radiotherapy planning such as stereotactic radiation therapy, have recently been performed, aiming to the development of personalized therapeutic strategies in patients with biochemical failure of prostate cancer. However, this needs an early and accurate location of sites of recurrence. Development of multimodality magnetic resonance imaging (MRI) and positron emission tomography (PET) permits to consider this objective. Thus, it is worthwhile to apprehend the respective performance of these imaging techniques in order to rationalize their use. We propose a review of the recent literature organized by technique and by location, regarding the performance of multimodality MRI and PET for restaging of patients with biochemical failure of prostate cancer initially treated with curative intent.

Topics: Adenocarcinoma; Brachytherapy; Carbon Radioisotopes; Choline; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Male; Multimodal Imaging; Neoplasm Recurrence, Local; Neoplasm Staging; Positron-Emission Tomography; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms; Radiopharmaceuticals; Salvage Therapy

Despite the increasing use of. 221 consecutive PET/CT were selected from 201 patients previously treated by radical prostatectomy (n = 31), pelvic radiation therapy (n = 60), or both (n = 94). 24 patients had no previous treatments, and 12 benefited from other focal treatments. In the whole population, dynamic acquisition modified final interpretation of 32/221 scans (14.5%) for residents, 26 (11.8%) for experts and 19 (8.6%) for consensual reading. No influence of previous treatments was found. The availability of a dynamic phase would have been responsible for treatment modification in 5/221 scans (2.3%). Considering only the prostate bed, dynamic acquisition modified the final interpretation in 7/125 (5.6%) studies (consensual reading) from patients with previous prostatic surgery and 4/84 (4.8%) scans from patients without a history of prostatic surgical intervention. No significant influence of dynamic acquisition was found on the final PET interpretation on prostate lodge accordingly to previous prostatic surgery.. The dynamic phase changes the interpretation of

Topics: Adenocarcinoma; Choline; Humans; Male; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prostate; Prostatic Neoplasms; Retrospective Studies

Topics: Adenocarcinoma; Aged; Betacoronavirus; Choline; Convalescence; Coronavirus Infections; COVID-19; Fluorine Radioisotopes; Humans; Lung; Lymph Nodes; Male; Pandemics; Pneumonia, Viral; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; SARS-CoV-2

The association between choline uptake and androgen receptor (AR) expression is suggested by the upregulation of choline kinase-alpha in prostate cancer. Recently, detection of AR aberration in cell-free DNA as well as early 18F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT) were associated with outcome in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone and enzalutamide. We aimed to make a direct comparison between circulating AR copy number (CN) and choline uptake at FCH-PET/CT. We analysed 80 mCRPC patients progressing after docetaxel treated with abiraterone (n = 47) or enzalutamide (n = 33). We analysed AR CN from plasma samples using digital PCR and Taqman CN assays and total lesion activity (TLA) and metabolic tumor volume (MTV) on FCH-PET/CT at baseline. A meaningful correlation was showed among AR gain and TLA/MTV compared to AR non-gained cases (P = 0.001 and P = 0.004, respectively), independently from type of treatment. Multivariate analysis revealed that AR CN and only TLA were associated with both shorter PFS (P < 0.0009 and P = 0.026, respectively) and OS (P < 0.031 and P = 0.039, respectively). AR gain appeared significantly correlated with choline uptake represented mainly by TLA. Further prospective studies are warranted to better address this pathway of AR-signalling and to identify multiplex biomarker strategies including plasma AR and FCH-PET/CT in mCRPC patients.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Androstenes; Antineoplastic Combined Chemotherapy Protocols; Benzamides; Biomarkers, Tumor; Chlorine; Choline; Docetaxel; Gene Dosage; Humans; Male; Middle Aged; Nitriles; Phenylthiohydantoin; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms, Castration-Resistant; Receptors, Androgen; Signal Transduction

We present the case of a 60-year-old male patient with T3b-N1, Gleason score 8, adenocarcinoma prostate with biochemical relapse (prostate-specific antigen, 5.2 μg/L) 1 year after radical treatment with 50.4-Gy 3-dimensional conformal radiotherapy and androgen deprivation therapy. Conventional imaging including contrast-enhanced abdominal CT and whole-body bone scintigraphy did not reveal any local recurrence or distant metastases. F-flourocholine PET/CT demonstrated a solitary, intensely avid (SUVmax, 9.2) osteolytic metastasis in the manubrium. Histopathology confirmed metastatic prostate adenocarcinoma.

Topics: Adenocarcinoma; Bone Neoplasms; Choline; Humans; Male; Middle Aged; Multimodal Imaging; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Tomography, X-Ray Computed; Whole Body Imaging

A 62-year-old patient with prostate adenocarcinoma underwent PET with radiolabeled choline (18F-Fcholine) for pretreatment staging of a high-risk prostate cancer. Images showed a significant mediastinal lymph node uptake of 18F-Fcholine. Owing to the rarity of spread to supradiaphragmatic lymph nodes, a surgical removal was performed, revealing anthracosis and no malignant cells. Even if its specificity seems better than 18F-FDG, false positives have been reported and other pathologies could mimic lymph node metastases. Consequently, histology should be performed so that the appropriate treatment can be initiated.

Topics: Adenocarcinoma; Anthracosis; Choline; False Positive Reactions; Humans; Lymphatic Metastasis; Male; Mediastinum; Middle Aged; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals

A 65-year-old patient with prostate adenocarcinoma was explored by 18F-fluorocholine (FCH) PET/CT for pretreatment staging because of a high risk of prostate cancer. Images showed multiple foci with increased uptake of 18F-FCH within some pelvic and retroperitoneal lymph nodes, osseous foci (iliac bones and sacrum), and much more unusual, increased uptake foci within some left supraclavicular and left axillary lymph nodes. Owing to the rarity of spread to supraclavicular lymph nodes, surgical removal was performed and revealed prostate cancer metastases.

Topics: Adenocarcinoma; Aged; Choline; Humans; Lymphatic Metastasis; Male; Multimodal Imaging; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Tomography, X-Ray Computed

To establish 18 fluorocholine-positron emission tomography/computed tomography (F-PET/CT) performances for the detection of local recurrence in a population of patients with biochemical failure after primary curative treatment for localized prostate carcinoma.. From February 2011 to February 2014, 55 patients underwent a F-PET/CT for biochemical relapse after primary radical therapy for prostate cancer localized or locally advanced. Primary therapies for prostate cancer were 19 radical prostatectomy, 18 radiotherapy, 13 radiotherapy with hormonal treatment, 3 brachytherapy. The median age was 65 years (50-79). The initial staging was 17 T1, 23 T2 and 15 T3, 52 were N0 and N1 3. The median PSA was 12 (3-127). The Gleason score was less than 7, equal to 7 and greater than 7 at 21, 25 and 9 patients respectively. The average time to recurrence was 69.5 months (8-147) with a median PSA of 2.9 ng/mL (0.48-41).. In 42 cases, F-PET/CT showed uptake, suggesting a recurrence, metastatic (6), nodal (26) or local isolated (10). The focal uptake in PET commissioned in 5 cases prostate biopsy, confirming the histological recurrence of prostate cancer in 4 cases. Among the 10 patients with isolated local recurrence, 8 underwent salvage radiotherapy. Of the 13 cases where the (F-PET/CT) showed no recurrence, 7 multiparametric MRI were performed. The MRI showed a local recurrence in 3 patients, the diagnoses were confirmed with prostate biopsy for two of them.. In our study, for the patients with biochemical relapse of prostate adenocarcinoma localized or locally advanced, (F-PET/CT) was able to detect local recurrence isolated in nearly half the cases but did not show sufficient sensitivity to exclude recurrence local if negative. It does not replace MRI or additional prostate biopsy.

Topics: Adenocarcinoma; Aged; Choline; Fluorine Radioisotopes; Humans; Male; Middle Aged; Multimodal Imaging; Neoplasm Recurrence, Local; Positron-Emission Tomography; Prostatic Neoplasms; Retrospective Studies; Tomography, X-Ray Computed

Topics: Adenocarcinoma; Aged; Cerebellar Neoplasms; Choline; Humans; Male; Multimodal Imaging; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Tomography, X-Ray Computed