Role of ¹⁸F-FCH PET/CT in Detecting Recurrences of Prostate Cancer After Curative Treatments

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Prostate cancer (PC) biochemical recurrence after curative treatment presents diagnostic challenges.
• Accurate staging is crucial for guiding subsequent management decisions.

Purpose of the Study:

• To evaluate the diagnostic performance of 18F-fluorocholine (18F-FCH) positron emission tomography/computed tomography (PET/CT) in prostate cancer patients experiencing biochemical recurrence.
• To assess the role of 18F-FCH PET/CT in patients treated with prostatectomy, radiotherapy, or both.

Main Methods:

• Retrospective analysis of 75 PC patients who underwent 18F-FCH PET/CT for biochemical recurrence.
• Patients were categorized into prostatectomy (PR), radiotherapy (RT), and combined (PR + RT) groups.
• Correlations between imaging findings, PSA values, and patient outcomes were analyzed using receiver operating characteristic (ROC) curves.

Main Results:

• 18F-FCH PET/CT identified relapses primarily in lymph nodes, bones, and the prostate bed.
• Agreement between imaging and outcome varied by treatment group (perfect in RT, moderate in PR, fair in PR + RT).
• Elevated PSA values correlated significantly with lymph node metastases and multiple metastatic sites.

Conclusions:

• 18F-FCH PET/CT remains a valid imaging modality for detecting prostate cancer recurrence, particularly with elevated PSA levels.
• The study supports the continued use of 18F-FCH PET/CT when prostate-specific membrane antigen tracers are not accessible.