F-18 fluorocholine-PET/CT (FCH-PET/CT) has emerged as a new diagnostic tool for the early detection of bone metastases in prostate cancer patients, according to a study in Molecular Imaging and Biology published July 9 online.
Mohsen Beheshti, MD, and colleagues from the PET/CT Center Linz, St. Vincent's Hospital-Nuclear Medicine & Endocrinology in Linz, Austria, evaluated the potential role of FCH-PET/CT for the assessment of bone metastases in patients with prostate cancer. The researchers also assessed the pattern of metabolic uptake by FCH in relation to morphologic changes on CT.
The study included 70 men with biopsy-proven prostate cancer of which 32 patients were evaluated preoperatively and 38 patients postoperatively of suspected recurrence or progression.
There was a significant correlation between tracer uptake and the density of sclerotic lesions. Out of 262 lesions which showed increased uptake on FCH-PET, 210 were interpreted as bone metastases, while 49 lesions had no detectable morphological changes on CT, the authors noted.
Although Hounsfield unit level of more than 825 in 56 sclerotic lesions were interpreted as highly suspicious for metastatic bone disease on CT, there was no FCH uptake. The FCH-negative sclerotic lesions might no longer be viable as they were mostly detected in patients who were under hormone therapy.
According to the results, FCH-PET/CT was 79 percent sensitive, 97 percent specific and 84 percent accurate in detecting bone metastases in prostate cancer patients.