ORIGINAL ARTICLE   

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 December;63(4):387-93

DOI: 10.23736/S1824-4785.18.02985-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Lung uptake of fluorine-18 fluoroethyl-choline PET-CT in patients with prostate cancer

Daniele A. PIZZUTO ¹ ✉, Salvatore ANNUNZIATA ¹, Francesco P. IERIA ¹, Carmelo CALDARELLA ², Maria A. ISGRÒ ³, Valerio LANNI ², Gaia BENCIVENGA ⁴, Vittoria RUFINI ¹, Alessandro GIORDANO ¹

¹ Unità Operativa Complessa di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Rome, Italy; ² Unit of Nuclear Medicine, Unità Operativa Complessa di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; ³ Chemical-Clinical and Hematologic Analysis Laboratory, Circolo e Fondazione Macchi Hospital, Varese, Italy; ⁴ PET-CT Center, Unità Operativa Complessa di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy

BACKGROUND: Metastatic spreading to the lungs is a negative prognostic factor in patients with prostate cancer (PC). Aim of our study was to assess the prevalence of lung PC metastases in patients with fluorine-18 fluoroethyl-choline (F-18-FECh) PET-CT positive lung lesions and the role of Gleason Score (GS) and common biochemical markers in predicting metastatic spreading to the lungs.
METHODS: We retrospectively evaluated the scans of 1283 patients ongoing (F-18-FECh) PET-CT for PC between May 2010 and July 2014. Patients with lung lesion with F-18-FECh uptake were included. Data concerning GS at diagnosis, “trigger” prostate-specific antigen (PSAtr), PSA doubling time (PSAdt), PSA velocity (PSAvel) and ongoing androgen deprivation therapy were collected. PET-CT findings were confirmed by histology or follow-up (FU) and classified as follows: inflammation, primary lung cancer or metastases from tumor other than PC, and lung metastases from PC.
RESULTS: Twenty-two patients with F-18-FECh positive lung lesion and available histology or FU were identified. PSAdt was significantly (P=0.029) shorter in patients with lung metastases from PC (median PSAdt 1.7 months, interquartile range [IQR] 1.5-4.1 months) than in patients without lung PC relapse (median PSAdt 6.7 months, IQR 3.9-7.8); PSAvel was significantly (P=0.019) higher in patients with lung metastases from PC (median PSAvel 3.2 ng/mL/month, IQR 0.65-6.65 ng/mL/month) than in patients without lung PC relapse (median PSAvel 0.3 ng/mL/month, IQR 0.2-0.5 ng/mL/month). Patients with lung metastases from PC had significantly (P=0.006) higher GS at diagnosis (median GS 8) than the other ones (median GS 7).
CONCLUSIONS: Our analysis shows that the prevalence of F-18-FECh positive lung metastases in patients with PC, especially with higher GS at diagnosis, is higher in presence of a steady increase in PSA values, confirmed by higher PSAvel and shorter PSAdt.

KEY WORDS: Prostate; Lung; Neoplasm metastasis; Choline