Imaging prostate cancer with 11C-choline PET/CT

Area of Science:

• Nuclear Medicine
• Radiology
• Oncology

Background:

• Prostate carcinoma (PCa) diagnosis and staging are critical for effective treatment planning.
• Accurate delineation of PCa from benign prostate conditions is essential for surgical and therapeutic decisions.

Purpose of the Study:

• To evaluate the efficacy of 11C-choline PET/CT in detecting and localizing prostate cancer.
• To differentiate PCa tissue from normal prostate, benign prostatic hyperplasia, and chronic prostatitis using PET/CT.

Main Methods:

• Twenty-six patients with biopsy-proven PCa underwent 11C-choline PET/CT after injection of the radiotracer.
• Maximal standardized uptake values (SUVs) of 11C-choline were determined in prostate segments.
• PET/CT findings were correlated with histopathology, PSA, Gleason score, and pT stage.

Main Results:

• 11C-choline uptake was significantly higher in PCa tissue (SUV 3.5 ± 1.3) compared to benign lesions (SUV 2.0 ± 0.6; P < 0.001).
• PCa was unambiguously located in 26/26 patients visually and 25/26 patients quantitatively.
• A threshold SUV of 2.65 achieved an area under the ROC curve of 0.89 ± 0.01 for PCa localization. Maximal SUV correlated with pT stage (P = 0.01).

Conclusions:

• 11C-Choline PET/CT accurately detects and localizes significant areas of PCa.
• The imaging modality effectively differentiates PCa from benign prostate tissues.
• Tumoral 11C-choline uptake is related to the pathological T stage of prostate cancer.