Standardization of acquisition protocols using PET/CT with ¹⁸F-Choline in prostate cancer

Area of Science:

• Nuclear Medicine
• Oncology
• Radiochemistry

Background:

• ¹⁸F-Choline Positron Emission Tomography/Computed Tomography (PET/CT) is valuable for prostate cancer imaging.
• Standardized acquisition protocols are crucial to minimize artifacts like urine interference and optimize lesion detection.

Purpose of the Study:

• To establish standardized ¹⁸F-Choline PET/CT acquisition protocols to mitigate urine interference.
• To identify the optimal time point for whole-body imaging in prostate cancer patients.
• To evaluate the efficacy of dual-point imaging in differentiating malignant from benign lesions.

Main Methods:

• Prospective study of 100 prostate cancer patients undergoing ¹⁸F-Choline PET/CT.
• Pelvic imaging immediately post-injection, followed by whole-body scans at 1 and 2 hours post-injection (p.i.).
• Analysis of Mean Standardized Uptake Value (SUVmax), SUV percentage change, and metabolic patterns (accumulative vs. clearance).

Main Results:

• Early imaging (0-1 hour) effectively identified prostate foci without significant urine interference.
• An accumulative pattern was observed in 42 patients, with significant SUVmax increases between time points.
• Clearance patterns were noted in 11 patients, particularly in supradiaphragmatic lymph nodes, while bone uptake consistently showed an accumulative pattern.

Conclusions:

• Dual-point imaging at 0-1 hour p.i. is optimal for prostate assessment.
• Dual-point imaging at 1-2 hours p.i. is superior for detecting supradiaphragmatic lymph nodes.
• 2-hour imaging enhances diagnostic confidence for infradiaphragmatic involvement, bone metastases, and inconclusive findings.