Consequence of the introduction of routine FCH PET/CT imaging in patients with prostate cancer: a dual centre survey

Abstract

Introduction.Fluorocholine(18F) (FCH) was introduced at the beginning of April 2010 in France, Slovenia and three other EU member states for the localisation of bone metastases of prostate cancer (PC) with PET.

Methods. In two centres (France/Slovenia), a survey of the number of nuclear medicine (NM) examinations in patients with PC was performed, covering 5 quarters since the introduction of FCH. For each examination, the clinical and biological circumstances were recorded, as well as the detection of bone or soft tissue foci.

Results. 688 NM examinations were performed for PC. NM examinations were performed for therapy monitoring and follow-up in 23% of cases. The number of FCH PET/CT grew rapidly between the 1^st and 5th period of the observation (+220%), while the number of bone scintigraphies (BS) and fluoride(18F) (FNa) PET/CT decreased (-42% and –23% respectively). FDG PET/CT remained limited to few cases of castrate-resistant or metastatic PC in Paris. The proportion of negative results was significantly lower with FCH PET/CT (14%) than with BS (49%) or FNa PET/CT (54%). For bone metastases, the detection rate was similar, but FCH PET/CT was performed on average at lower PSA levels and was less frequently doubtful (4% vs. 28% for BS). FCH PET/CT also showed foci in prostatic bed (53% of cases) or in soft tissue (35% of cases).

Conclusion. A rapid development of FCH PET/CT was observed in both centres and led to a higher detection rate of PC lesions.