Abstract:
OBJECTIVE : Imaging with fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed
tomography (18F-FDG PET/CT) has, until recently provided disappointing results with low sensitivity ranging
from 31%-64% in patients with well-differentiated prostate cancer (PC) at all prostatic specific antigen
(PSA) levels while fluorine-18-fluoroethylcholine (18F-FECh) PET/CT showed about 85% sensitivity in restaging
patients after relapse. We present our experience of the sensitivity of 18F-FECh PET/CT in the early
stages of PC. SUBJECT AND METHODS : Fifty patients were prospectively recruited and imaged, of which 40
fulfilled all inclusion criteria. Our patients had an average age of 65.5 years. Fifteen patients were referred
for initial staging, with the remaining 25 referred for restaging and all patients had histologically confirmed
adenocarcinoma. Patients were imaged by 18F-FECh PET/CT. Findings were evaluated qualitatively and
quantitatively and compared to the results of histology, PSA, Gleason score and bone scintigraphy. The
prostate SUV max was also used. RESULTS : Thirty-one patients demonstrated abnormal pelvic- and or extrapelvic
findings on 18F-FECh PET/CT, which was consistent with malignant or metastatic involvement. The
prostate SUVmax could not be used to predict the presence or absence of metastatic disease. CONCLUSION :
Findings of this paper suggest that 18F-FECh PET/CT in 30/40 cases (estimated as 75%) was helpful in the
initial staging, restaging and lymph node detection of patients with PC. The SUVmax was not helpful. We
diagnosed more PC cases in our African-American patients as compared to the Caucasian patients.
