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Relationship between PSA kinetics and [18F]fluorocholine PET/CT detection rates of recurrence in patients with prostate cancer after total prostatectomy

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Abstract

Purpose

The aim of the present study was to identify prostate-specific antigen (PSA) threshold levels, as well as PSA velocity, progression rate and doubling time in relation to the detectability and localization of recurrent lesions with [18F]fluorocholine (FC) PET/CT in patients after radical prostatectomy.

Methods

The study group comprised 82 consecutive patients with biochemical relapse after radical prostatectomy. PSA levels measured at the time of imaging were correlated with the FC PET/CT detection rates in the entire group with PSA velocity (in 48 patients), with PSA doubling time (in 47 patients) and with PSA progression (in 29 patients).

Results

FC PET/CT detected recurrent lesions in 51 of the 82 patients (62%). The median PSA value was significantly higher in PET-positive than in PET-negative patients (4.3 ng/ml vs. 1.0 ng/ml; p < 0.01). The optimal PSA threshold from ROC analysis for the detection of recurrent prostate cancer lesions was 1.74 ng/ml (AUC 0.818, 82% sensitivity, 74% specificity). Significant differences between PET-positive and PET-negative patients were found for median PSA velocity (6.4 vs. 1.1 ng/ml per year; p < 0.01) and PSA progression (5.0 vs. 0.3 ng/ml per year, p < 0.01) with corresponding optimal thresholds of 1.27 ng/ml per year and 1.28 ng/ml per year, respectively. The PSA doubling time suggested a threshold of 3.2 months, but this just failed to reach statistical significance (p = 0.071).

Conclusion

In a study cohort of patients with biochemical recurrence of prostate cancer after radical prostatectomy there emerged clear PSA thresholds for the presence of FC PET/CT-detectable lesions.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Munich, Marchioninistr. 15, 81377, Munich, Germany

    Vera Graute, Nathalie Jansen, Christopher Übleis, Paul Cumming, Katharina Klanke, Reinhold Tiling, Peter Bartenstein & Marcus Hacker

  2. Department of Urology, University of Munich, Munich, Germany

    Michael Seitz

  3. Department of Nuclear Medicine, Bundeswehrkrankenhaus Ulm, Ulm, Germany

    Markus Hartenbach

  4. Institute of Clinical Radiology, University of Munich, Munich, Germany

    Michael Karl Scherr & Sven Thieme

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  1. Vera Graute
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Correspondence to Marcus Hacker.

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Graute, V., Jansen, N., Übleis, C. et al. Relationship between PSA kinetics and [18F]fluorocholine PET/CT detection rates of recurrence in patients with prostate cancer after total prostatectomy. Eur J Nucl Med Mol Imaging 39, 271–282 (2012). https://doi.org/10.1007/s00259-011-1970-2

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  • DOI: https://doi.org/10.1007/s00259-011-1970-2

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