Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press45310.17650/1726-9776-2015-11-2-46-54PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫDual-stage 18F-fluorocholine PET/CT scanning for biochemical recurrences of prostate cancerПЭТ/КТ с 18F-фторхолином в режиме двухэтапного сканирования при биохимических рецидивах рака предстательной железыDolgushinM. B.ДолгушинМ. Б.
Russian Federation
OdzharovaA. A.ОджароваА. А.
Russian Federation
MikhailovA. I.МихайловА. И.
Russian Federation
azatmihailov@gmail.comShiryaevS. V.ШиряевС. В.
Russian Federation
TulinP. E.ТулинП. Е.
Russian Federation
NevzorovD. I.НевзоровД. И.
Russian Federation
MatveevV. B.МатвеевВ. Б.
Russian Federation
Department of Positron Emission Tomography N.N. Blokhin Russian Cancer Research CenterОтделение позитронной эмиссионной томографии ФГБНУ «Российский онкологический научный центр им. Н. Н. Блохина»23, Kashirskoe Shosse, Moscow 115478, RussiaРоссия, 1154787, Москва, Каширское шоссе, 23Depatment of Radionuclide Diagnosis and Radionuclide Therapy N.N. Blokhin Russian Cancer Research Centerотдел радионуклидной диагностики и радионуклидной терапии ФГБНУ «Российский онкологический научный центр им. Н. Н. Блохина»Urology Department, N.N. Blokhin Russian Cancer Research Centerурологическое отделение ФГБНУ «Российский онкологический научный центр им. Н. Н. Блохина»3006201511246541906201519062015https://oncourology.abvpress.ru/oncur/article/view/453

PET/CT with 18F-fluorocholine, based on an assessment of phosphatidylcholine biodistribution, is an effective method in the diagnosis of biochemical recurrence of prostate cancer. According to results of our study on 71 patients (PSA level 1,775 (0.0245, 56.0975) ng/mL), the sensitivity of two-stage PET/CT with 18F-fluorocholine was 66.7 % (CI 55.3–78 0 %), and specificity – 80 % (CI 44.9–100.0 %), the overall accuracy of the method ranged from 56.7 to 78.5 %. The results show the feasibility of two-staged PET/CT with 18F-fluorocholine in biochemical recurrence of prostate cancer.

Позитронная эмиссионная томографии/компьютерная томография (ПЭТ/КТ) с 18F-фторхолином, основанная на оценке биораспределения фосфатидилхолина, является эффективным методом диагностики при биохимических рецидивах рака предстательной железы (РПЖ). По результатам нашего исследования, основанном на анализе 71 наблюдения пациентов с биохимическим рецидивом РПЖ (уровень простатспецифического антигена в сыворотке крови 1,775 (0,0245; 56,0975) нг/мл, чувствительность двухэтапной ПЭТ/КТ с 18F-фторхолином составила 66,7 %, доверительный интервал (ДИ) 55,3–78,0, при специфичности 80 % (ДИ 44,9–100,0), общая точность метода колебалась от 56,7 до 78,5 %. Полученные результаты свидетельствуют о целесообразности применения ПЭТ/КТ с 18F-фторхолином в режиме двухэтапного сканирования при биохимических рецидивах РПЖ.

PET/CTtwo-stagedprostate cancer18F-fluorocholinecholinebiochemical recurrenceprostatectomyпозитронная эмиссионная томография/компьютерная томография, двухэтапное сканирование, рак предстательной железы, 18F-фторхолин, холин, биохимический рецидив, радикальная простатэктомия1. Статистика злокачественных новообразований в России и странах СНГ в 2008 г. Под ред. М. И. Давыдова, Е. М. Аксель. Вестник РОНЦ им. Н. Н. Блохина РАМН, 2010. Т. 21.Статистика злокачественных новообразований в России и странах СНГ в 2008 г. Под ред. М. И. Давыдова, Е. М. Аксель. Вестник РОНЦ им. Н. Н. Блохина РАМН, 2010. Т. 21.2. Злокачественные новообразования в России в 2012 году (заболеваемость и смертность). Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М.: ФГБУ «МНИОИ им. П. А. Герцена» Минздрава России, 2014.Злокачественные новообразования в России в 2012 году (заболеваемость и смертность). Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М.: ФГБУ «МНИОИ им. П. А. Герцена» Минздрава России, 2014.3. Ferlay J., Soerjomataram I., Dikshit R. et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136: E359–86.Ferlay J., Soerjomataram I., Dikshit R. et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136: E359–86.4. Budiharto T., Joniau S., Lerut E. et al. Prospective evaluation of 11C-choline positron emission tomography/computed tomography and diffusion weighted magnetic resonance imaging for the nodal staging of prostate cancer with a high risk of lymph node metastases. Eur Urol 2011;60:125–30.Budiharto T., Joniau S., Lerut E. et al. Prospective evaluation of 11C-choline positron emission tomography/computed tomography and diffusion weighted magnetic resonance imaging for the nodal staging of prostate cancer with a high risk of lymph node metastases. Eur Urol 2011;60:125–30.5. Etzioni R., Cha R., Feuer E. J., Davidov O. Asymptomatic incidence and duration of prostate cancer. Am J Epidemiol 1998;148(8):775–85.Etzioni R., Cha R., Feuer E. J., Davidov O. Asymptomatic incidence and duration of prostate cancer. Am J Epidemiol 1998;148(8):775–85.6. Cimitan M., Bortolus R., Morassut S. et al. [18F] fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med 2006;33(12):1387–98.Cimitan M., Bortolus R., Morassut S. et al. [18F] fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med 2006;33(12):1387–98.7. Hara T., Kosaka N., Kishi H. PET imaging of prostate cancer using carbon-11-choline. J Nucl Med1998;39(6):990–5.Hara T., Kosaka N., Kishi H. PET imaging of prostate cancer using carbon-11-choline. J Nucl Med1998;39(6):990–5.8. Mottet N., Bastian P. J., Bellmunt J. et al. EAU guidelines on prostate cancer. Update April 2014. European Association of Urology. http://www.uroweb.org/guidelines/onlineguidelines/.Mottet N., Bastian P. J., Bellmunt J. et al. EAU guidelines on prostate cancer. Update April 2014. European Association of Urology. http://www.uroweb.org/guidelines/onlineguidelines/.9. Arlen P. M., Bianco F., Dahut W. L. et al. Prostate Specific Antigen Working Group. Prostate Specific Antigen Working Group guidelines on prostate specific antigen doubling time. J Urol 2008;179(6):2181–5.Arlen P. M., Bianco F., Dahut W. L. et al. Prostate Specific Antigen Working Group. Prostate Specific Antigen Working Group guidelines on prostate specific antigen doubling time. J Urol 2008;179(6):2181–5.10. Leventis K., Shariat S. F., Slawin K. M. Local recurrence after radical prostatectomy: correlation of US features with prostatic fossa biopsy findings. Radiology 2001;219(2):432–9.Leventis K., Shariat S. F., Slawin K. M. Local recurrence after radical prostatectomy: correlation of US features with prostatic fossa biopsy findings. Radiology 2001;219(2):432–9.11. Schmid D. T., John H., Zweifel R. et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005;235:623–8.Schmid D. T., John H., Zweifel R. et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005;235:623–8.12. Schmid H. P., McNeal J. E., Stamey T. A. Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer 1993;71(6):2031–40.Schmid H. P., McNeal J. E., Stamey T. A. Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer 1993;71(6):2031–40.13. Sanz G., Rioja J., Zudaire J. et al. PET and prostate cancer. World J Urol 2004;22:351–2.Sanz G., Rioja J., Zudaire J. et al. PET and prostate cancer. World J Urol 2004;22:351–2.14. Karam J. A., Mason R. P., Koeneman K. S. et al. Molecular imaging in prostate cancer. J Cell Biochem 2003;90:473–83.Karam J. A., Mason R. P., Koeneman K. S. et al. Molecular imaging in prostate cancer. J Cell Biochem 2003;90:473–83.15. Turkbey B., Pinto P. A., Mani H. et al. Prostate cancer: value of multiparametric MR imaging at 3 T for detection – histopathologic correlation. Radiology 2010;255(1):89–99.Turkbey B., Pinto P. A., Mani H. et al. Prostate cancer: value of multiparametric MR imaging at 3 T for detection – histopathologic correlation. Radiology 2010;255(1):89–99.16. Turkbey B., Mani H., Shah V. et al. Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. J Urol 2011;186(5):1818–24.Turkbey B., Mani H., Shah V. et al. Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. J Urol 2011;186(5):1818–24.17. Selnaes K. M., Heerschap A., Jensen L. R. et al. Peripheral zone prostate cancer localization by multiparametric magnetic resonance at 3 T: unbiased cancer identification by matching to histopathology. Invest Radiol 2012;47(11):624–33.Selnaes K. M., Heerschap A., Jensen L. R. et al. Peripheral zone prostate cancer localization by multiparametric magnetic resonance at 3 T: unbiased cancer identification by matching to histopathology. Invest Radiol 2012;47(11):624–33.18. Bratan F., Niaf E., Melodelima C. et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 2013;23(7):2019–29.Bratan F., Niaf E., Melodelima C. et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 2013;23(7):2019–29.19. Hoeks C. M., Schouten M. G., Bomers J. G. et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 2012;62(5):902–9.Hoeks C. M., Schouten M. G., Bomers J. G. et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 2012;62(5):902–9.20. Puech P., Rouviere O., Renard-Penna R. et al. Prostate Cancer Diagnosis: Multiparametric MR-targeted Biopsy with Cognitive and Transrectal US-MR Fusion Guidance versus Systematic Biopsy- Prospective Multicenter Study. Radiology 2013;268(2):461–9.Puech P., Rouviere O., Renard-Penna R. et al. Prostate Cancer Diagnosis: Multiparametric MR-targeted Biopsy with Cognitive and Transrectal US-MR Fusion Guidance versus Systematic Biopsy- Prospective Multicenter Study. Radiology 2013;268(2):461–9.21. Apolo A. B., Pandit-Taskar N., Morris M. J. Novel tracers and their development for the imaging of metastatic prostate cancer. J Nucl Med 2008;49:2031–41.Apolo A. B., Pandit-Taskar N., Morris M. J. Novel tracers and their development for the imaging of metastatic prostate cancer. J Nucl Med 2008;49:2031–41.22. Husarik D. B., Miralbell R., Dubs M. et al. Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 2008;35:253–63.Husarik D. B., Miralbell R., Dubs M. et al. Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 2008;35:253–63.23. Effert P. J., Bares R., Handt S. et al. Metabolic imaging of untreated prostate cancer by positron emission tomography with 18fluorine-labeled deoxyglucose. J Urol 1996;155:994–8.Effert P. J., Bares R., Handt S. et al. Metabolic imaging of untreated prostate cancer by positron emission tomography with 18fluorine-labeled deoxyglucose. J Urol 1996;155:994–8.24. Wetter A., Lipponer C., Nensa F. et al. Evaluation of the PET component of simultaneous [18F] choline PET/MRI in prostate cancer: comparison with [18F] choline PET/CT. Eur J Nucl Med Mol Imaging 2014;41(1):79–88.Wetter A., Lipponer C., Nensa F. et al. Evaluation of the PET component of simultaneous [18F] choline PET/MRI in prostate cancer: comparison with [18F] choline PET/CT. Eur J Nucl Med Mol Imaging 2014;41(1):79–88.25. Wu L. M., Xu J. R., Gu H. Y. et al. Role of magnetic resonance imaging in the detection of local prostate cancer recurrence after external beam radiotherapy and radical prostatectomy. Clin Oncol 2013;25(4):252–64.Wu L. M., Xu J. R., Gu H. Y. et al. Role of magnetic resonance imaging in the detection of local prostate cancer recurrence after external beam radiotherapy and radical prostatectomy. Clin Oncol 2013;25(4):252–64.26. Джужа Д. А. Позитронная эмиссионная томография в онкоурологии. Лучевая диагностика, лучевая терапия 2013;2(3):67–75.Джужа Д. А. Позитронная эмиссионная томография в онкоурологии. Лучевая диагностика, лучевая терапия 2013;2(3):67–75.27. Mease R. C. Radionuclide based imaging of prostate cancer. Curr Top Med Chem 2010;10:1600–16.Mease R. C. Radionuclide based imaging of prostate cancer. Curr Top Med Chem 2010;10:1600–16.28. Heidenreich A., Bellmunt J., Bolla M. et al. EAU guidelines on prostate cancer – part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 2011;59(1):61–71.Heidenreich A., Bellmunt J., Bolla M. et al. EAU guidelines on prostate cancer – part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 2011;59(1):61–71.29. Emonds K. M., Swinnen J. V., Mortelman s.L., Mottaghy F. M. Molecular imaging of rostate cancer. Methods 2009;48:193–9. 30. Gutman F., Afl alo-Hazan V., Kerrou K. et al. 8F-Choline PET/CT for initial staging of advanced prostate cancer. AJR 2006;187:618–21.Emonds K. M., Swinnen J. V., Mortelman s.L., Mottaghy F. M. Molecular imaging of rostate cancer. Methods 2009;48:193–9. 30. Gutman F., Afl alo-Hazan V., Kerrou K. et al. 8F-Choline PET/CT for initial staging of advanced prostate cancer. AJR 2006;187:618–21.31. Schillaci O., Calabria F., Tavolozza M., Ciccio C. et al. 18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer. Nucl Med Commun 2010;31:39–4.Schillaci O., Calabria F., Tavolozza M., Ciccio C. et al. 18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer. Nucl Med Commun 2010;31:39–4.32. Sutinen E., Nurmi M., Roivainen A. et al. Kinetics of 11C Choline uptake in prostate cancer: a PET study. Eur J Nucl Med Mol Imaging 2004;31:317–24.Sutinen E., Nurmi M., Roivainen A. et al. Kinetics of 11C Choline uptake in prostate cancer: a PET study. Eur J Nucl Med Mol Imaging 2004;31:317–24.33. Chiti A. The rising PET: the increasing use of choline PET/CT in prostate cancer. Eur J Nucl Med 2011;38:53–54.Chiti A. The rising PET: the increasing use of choline PET/CT in prostate cancer. Eur J Nucl Med 2011;38:53–54.34. Greco C., Cascini O., Tamburini G. et al. Is there a role for positron emission tomography imaging in the early evaluation of prostate cancer relapse? Prostate Cancer and Prostatic Diseases 2008;11:121–8.Greco C., Cascini O., Tamburini G. et al. Is there a role for positron emission tomography imaging in the early evaluation of prostate cancer relapse? Prostate Cancer and Prostatic Diseases 2008;11:121–8.35. Piccardo A., Paparo F., Picazzo R. et al. Value of Fused 18F-Choline-PET/MRI to Evaluate Prostate Cancer Relapse in Patients Showing Biochemical Recurrence after EBRT: Preliminary Results. BioMed Research International 2014. http://www.ncbi.nlm.nih. gov/pmc/articles/PMC4022120/.Piccardo A., Paparo F., Picazzo R. et al. Value of Fused 18F-Choline-PET/MRI to Evaluate Prostate Cancer Relapse in Patients Showing Biochemical Recurrence after EBRT: Preliminary Results. BioMed Research International 2014. http://www.ncbi.nlm.nih. gov/pmc/articles/PMC4022120/.36. Beheshti M., Langsteger W., Fogelman I. Prostate cancer: role of SPECT and PET in imaging bone metastases. Semin Nucl Med 2009;39(6):396–407.Beheshti M., Langsteger W., Fogelman I. Prostate cancer: role of SPECT and PET in imaging bone metastases. Semin Nucl Med 2009;39(6):396–407.37. Beheshti M., Imamovic L., Broiger G. et al. 18F choline PET/CT in the preoperative staging of prostate cancer in patients with intermediate or high risk of extracapsular disease: a prospective study of 130 patients. Radiology 2010;254:925–33.Beheshti M., Imamovic L., Broiger G. et al. 18F choline PET/CT in the preoperative staging of prostate cancer in patients with intermediate or high risk of extracapsular disease: a prospective study of 130 patients. Radiology 2010;254:925–33.38. Tilki D., Reich O., Graser A. et al. 18FFluoroethylcholine PET/CT identifies lymph node etastasis in patients with prostatespecific antigen failure after radical prostatectomy but underestimates its extent. Eur Urol 2013;63:792–6.Tilki D., Reich O., Graser A. et al. 18FFluoroethylcholine PET/CT identifies lymph node etastasis in patients with prostatespecific antigen failure after radical prostatectomy but underestimates its extent. Eur Urol 2013;63:792–6.39. Kwee S. A., Wei H., Sesterhenn I. et al. Localization of primary prostate cancer with dual-phase 18F-fluorocholine PET. J Nucl Med 2006; 47(2): 262–9.Kwee S. A., Wei H., Sesterhenn I. et al. Localization of primary prostate cancer with dual-phase 18F-fluorocholine PET. J Nucl Med 2006; 47(2): 262–9.40. O»Brien M. F., Cronin A. M., Fearn P. A. et al. Pretreatment prostate-specific antigen (PSA) velocity and doubling time are associated with outcome but neither improves prediction of outcome beyond pretreatment PSA alone in patients treated with radical prostatectomy. J Clin Oncol 2009;27(22):3591–7.O»Brien M. F., Cronin A. M., Fearn P. A. et al. Pretreatment prostate-specific antigen (PSA) velocity and doubling time are associated with outcome but neither improves prediction of outcome beyond pretreatment PSA alone in patients treated with radical prostatectomy. J Clin Oncol 2009;27(22):3591–7.41. Zeisel S. H. Dietary choline: biochemistry, physiology, and pharmacology. Ann Rev Nutr 1981;1:95–121.Zeisel S. H. Dietary choline: biochemistry, physiology, and pharmacology. Ann Rev Nutr 1981;1:95–121.42. Carolan P., Hunt C., McConnell D. et al. Radiation exposure reduction to PET technologists with the use of an automated dosage infusion system. J Nucl Med 2012;53:2185.Carolan P., Hunt C., McConnell D. et al. Radiation exposure reduction to PET technologists with the use of an automated dosage infusion system. J Nucl Med 2012;53:2185.43. Massaro A., Ferretti A., Secchiero C. et al. Optimising 18F-choline PET/CT acquisition protocol in prostate cancer patients. North Am J Med Sci 2012;4(9):416.Massaro A., Ferretti A., Secchiero C. et al. Optimising 18F-choline PET/CT acquisition protocol in prostate cancer patients. North Am J Med Sci 2012;4(9):416.44. Von Eyben F. E., Kairemo K. Metaanalysis of 11C-choline and 18F-choline PET/CT for management of patients with rostate cancer. Nucl Med Commun 2014;35(3):221–30.Von Eyben F. E., Kairemo K. Metaanalysis of 11C-choline and 18F-choline PET/CT for management of patients with rostate cancer. Nucl Med Commun 2014;35(3):221–30.45. Pinaquy J. B., Clermont–Galleran D., Pasticier G. et al. Comparative effectiveness of [18F]-fluorocholine PET-CT and pelvic MRI with diffusion-weighted imaging for staging in patients with high-risk prostate cancer. Prostate 2015;75(3):323–31.Pinaquy J. B., Clermont–Galleran D., Pasticier G. et al. Comparative effectiveness of [18F]-fluorocholine PET-CT and pelvic MRI with diffusion-weighted imaging for staging in patients with high-risk prostate cancer. Prostate 2015;75(3):323–31.46. Kjölhede H., Ahlgren G., Almquist H. et al. 18F-fluorocholine PET/CT compared with extended pelvic lymph node dissection in high-risk prostate cancer. World J Urol 2014;32(4):965–70.Kjölhede H., Ahlgren G., Almquist H. et al. 18F-fluorocholine PET/CT compared with extended pelvic lymph node dissection in high-risk prostate cancer. World J Urol 2014;32(4):965–70.47. Agarwal N., Sonpavde G., Sternberg C. N. Novel molecular targets for the therapy of castrationresistant prostate cancer. Eur Urol 2012;61:950–60.Agarwal N., Sonpavde G., Sternberg C. N. Novel molecular targets for the therapy of castrationresistant prostate cancer. Eur Urol 2012;61:950–60.48. Holland-Letz T., Giesel F. L., Kratochwil C., Haufe S. PET imaging with a [68Ga] gallium-labelled PSMA ligand for the diagnosis of prostate cancer: Biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging 2013;40:486–95.Holland-Letz T., Giesel F. L., Kratochwil C., Haufe S. PET imaging with a [68Ga] gallium-labelled PSMA ligand for the diagnosis of prostate cancer: Biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging 2013;40:486–95.49. Hong H., Zhang Y., Sun J., Cai W. Positron emission tomography imaging of prostate cancer. Amino Acids 2010;39:11–27.Hong H., Zhang Y., Sun J., Cai W. Positron emission tomography imaging of prostate cancer. Amino Acids 2010;39:11–27.