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A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
Laura EVANGELISTA 1, Fabio ZATTONI 2, Andrea GUTTILLA 2, Umberto BASSO 3, Filiberto ZATTONI 2
1 Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV, IRCCS, Padua, Italy; 2 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Italy; 3 Oncology Unit 1, Veneto Institute of Oncology IOV, IRCCS, Padua, Italy
BACKGROUND: To evaluate how neoadjuvant androgen deprivation therapy (ADT) can impact 18F- Choline uptake in primary prostate cancer (PC) and its metastases before radical prostatectomy (RP) or radiation therapy (RT).
METHODS: We retrospectively reviewed images of 79 PC patients undergoing 18F-Choline PET/CT before RP or RT. Based on concomitant administration of neoadjuvant ADT at the time of 18F-Choline PET/CT, patients were subdivided into naïve group (Group 1) and neoadjuvant ADT group (Group 2). PET/CT results, SUVmax and metabolic tumor volume (MTV) for each site were re-assessed by two nuclear medicine physicians with more than 5 years of experience. A chi-square and a U-Mann Whitney test were used to compare the two groups.
RESULTS: Sixty-two patients were included in Group 1, while 17 in Group 2. PET/CT was positive in all patients, in particular: 54 had a significant uptake in prostate alone, 12 in prostate plus lymph nodes (LN), 4 in prostate plus LN and bone, 3 in prostate plus bone and 6 in prostate plus other organs (such as lung or thyroid). PET/CT was more frequently positive in a different site, outside the prostate, in Group 1 as compared to Group 2 (p<0.001). Conversely, median SUVmax and MTV in the prostate resulted significantly lower in Group 2 than in Group 1 (5.34 vs 7.72 and 3.66 vs. 6.86 cm3, respectively; both p<0.05).
CONCLUSIONS: PET/CT could have an important role in prostate cancer staging before primary treatment; however, before imaging, hormonal therapy status should be carefully evaluated.