n-n-dimethyl-n-(18f)fluoromethyl-2-hydroxyethylammonium and Carcinoma

The primary objective of this study was to assess clinical outcomes in patients with oligometastatic prostate cancer recurrence after single or repeated salvage radiation treatment.. Forty-nine consecutive prostate cancer patients diagnosed with oligometastatic recurrence on Ch-PET have been prospectively treated. Seven (23%) patients had castrate-resistant disease. Clinical outcomes were assessed using the Kaplan-Meier method. Potential prognostic factors were examined using univariate proportional hazards regression.. The treatments administered to the initial oligorecurrence sites were intensity-modulated radiotherapy (IMRT) ± ADT (26 patients; 53%) and stereotactic ablative radiotherapy (SABR) ± ADT (23 patients; 47%). With a median follow-up of 24 months (range 6-39), 24 patients developed a biochemical failure. Twenty out of the 24 relapsed patients underwent a second Ch-PET/CT. Seven patients presented poly-metastatic relapse and 10 oligometastatic diseases. Six of 10 patients with a second oligorecurrence were treated again with SABR. Overall, 102 lesions were treated. Local control was detected in 45 (91.8%) patients. No relevant (grade ≥ 2) toxicity was reported, and there was no grade 3 toxicity. On univariate analysis, none of the variables were significantly predicted for clinical disease-free survival. At last follow-up visit, 24 patients (40%) were free from biochemical failure and 37 (71%) patients were free from clinical disease. The 2-year OS and PCSS were 91.8% and 95.9% respectively.. Salvage IMRT or SBRT of oligometastatic prostate cancer recurrence is associated with a prolonged cDFS. This may result in a longer time to develop castrate-resistant disease and a longer time without systemic therapies.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Bone Neoplasms; Carcinoma; Choline; Fluorine Radioisotopes; Humans; Kaplan-Meier Estimate; Lymph Nodes; Male; Middle Aged; Neoplasm Recurrence, Local; Positron Emission Tomography Computed Tomography; Proportional Hazards Models; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Radiosurgery; Radiotherapy, Intensity-Modulated; Salvage Therapy

Prostate carcinoma is the most common cancer in men. After local therapy, disease recurs in many patients. A choline PET/CT is indicated in case of biochemical relapse of prostate carcinoma to determine the site of recurrence (local and/or distant) and to help select the next line of therapy. Choline PET-CT is also known to show an elevated uptake in hyperfunctioning parathyroid adenoma. This case report shows the difficulty to distinguish between both entities if they occur simultaneously in an oncologic patient.

Topics: Adenoma; Carcinoma; Choline; Diagnosis, Differential; Humans; Lymphatic Metastasis; Male; Middle Aged; Parathyroid Neoplasms; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals

F-choline PET/CT was performed for suspected prostate cancer relapse in a 67-year-old man with hip pain and a rapid rise in prostate-specific antigen values (1.1 ng/mL). PET imaging showed an area of increased F-choline bone uptake in the right ischium. Coregistered CT images showed a lytic bone lesion. The infrequent CT appearance of a possible prostate carcinoma metastasis led to additional laboratory testing that showed a monoclonal γ-peak and to subsequent biopsy, which revealed a solitary plasmocytoma.

Topics: Aged; Bone Neoplasms; Carcinoma; Choline; Humans; Incidental Findings; Male; Multiple Myeloma; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals

A 79-year-old man underwent F-choline PET/CT for biochemical recurrence of prostate cancer. PET/CT images showed an area of elevated radiopharmaceutical uptake in a left pelvic node. In addition, a small focus of increased radiolabeled choline accumulation was seen in a small nodule of the right breast, which was later histologically characterized as an infiltrating ductal carcinoma. In this patient, choline PET/CT was critical in localizing prostate cancer recurrence and identifying a second unsuspected malignancy.

Topics: Aged; Breast Neoplasms, Male; Carcinoma; Choline; Humans; Incidental Findings; Male; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals