Visualization of Prostate Cancer with 11C-Choline Positron Emission Tomography (original) (raw)
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[ 11C]Choline as a PET biomarker for assessment of prostate cancer tumor models
Bioorganic & medicinal …, 2004
[11C]Choline has been evaluated as a positron emission tomography (PET) biomarker for assessment of established human prostate cancer tumor models. [11C]Choline was prepared by the reaction of [11C]methyl triflate with 2-dimethylaminoethanol (DMAE) and isolated and purified by solid-phase extraction (SPE) method in 60–85% yield based on [11C]CO2, 15–20 min overall synthesis time from end of bombardment (EOB), 95–99% radiochemical purity and specific activity >0.8 Ci/μmol at end of synthesis (EOS). The biodistribution of [11C]choline was determined at 30 min post iv injection in prostate cancer tumor models C4-2, PC-3, CWR22rv, and LNCaP tumor-bearing athymic mice. The results showed the accumulation of [11C]choline in these tumors was 1.0% dose/g in C4-2 mouse, 0.4% dose/g in PC-3 mice, 3.2% dose/g in CWR22rv mice, and 1.4% dose/g in LNCaP mice; the ratios of tumor/muscle (T/M) and tumor/blood (T/B) were 2.3 (T/M, C4-2), 1.4 (T/M, PC-3), 2.5 (T/M, CWR22rv), 1.2 (T/M, LNCaP) and 2.6 (T/B, C4-2), 2.6 (T/B, PC-3), 7.8 (T/B, CWR22rv), 3.2 (T/B, LNCaP), respectively. The micro-PET imaging of [11C]choline in prostate cancer tumor models was acquired from a C4-2, PC-3, CWR22rv, or LNCaP implanted mouse at 30 min post iv injection of 1 mCi of the tracer using a dedicated high resolution (<3 mm full-width at half-maximum) small FOV (field-of-view) PET imaging system, IndyPET-II scanner, developed in our laboratory, which showed the accumulation of [11C]choline in C4-2, PC-3, CWR22rv, or LNCaP tumor implanted in a nude athymic mouse. The initial dynamic micro-PET imaging data indicated the average T/M ratios were approximately 3.0 (C4-2), 2.1 (PC-3), 3.5 (CWR22rv), and 3.3 (LNCaP), respectively, which showed the tumor accumulation of [11C]choline in all four tumor models is high. These results suggest that there are significant differences in [11C]choline accumulation between these different tumor types, and these differences might offer some useful measure of tumor biological process.In vivo evaluation including biodistribution and micro-PET (positron emission tomography) imaging studies of [11C]choline as a PET biomarker in four established human prostate cancer tumor models C4-2, PC-3, CWR22rv, and LNCaP tumor-bearing athymic mice is reported.
Experience with carbon-11 choline positron emission tomography in prostate carcinoma
European Journal of Nuclear Medicine and Molecular Imaging, 2000
We investigated the potential of carbon-11 choline positron emission tomography (PET) for the detection of lymph node and bone metastases in prostate cancer. A total of 23 patients were studied (known metastases: 8; suspicion of metastases: 3; primary staging: 12). Whole-body PET imaging was performed 5 min after injection of the tracer and completed within 1 h. Focally increased tracer uptake in bone or abdominal lymph node regions was interpreted as representing tumour involvement. All known bone and lymph node metastases could be recognized by [ 11 C]choline PET. One out of ten negative scans for primary staging was falsenegative (lymph node <1 cm) and one out of two positive scans was false-positive with regard to lymph node involvement (focal bowel activity). It is concluded that [ 11 C]choline PET is a promising new tool for the primary staging of prostate cancer, with lymph node and bone metastases demonstrating high tracer uptake. Therapeutic management could be influenced by these results in that the technique may permit avoidance of surgical lymph node exploration.
Imaging prostate cancer with 11C-choline PET/CT
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2006
The ability of 11C-choline and multimodality fusion imaging with integrated PET and contrast-enhanced CT (PET/CT) was investigated to delineate prostate carcinoma (PCa) within the prostate and to differentiate cancer tissue from normal prostate, benign prostate hyperplasia, and focal chronic prostatitis. All patients with PCa gave written informed consent. Twenty-six patients with clinical stage T1, T2, or T3 and biopsy-proven PCa underwent 11C-choline PET/CT after intravenous injection of 1,112 +/- 131 MBq 11C-choline, radical retropubic prostatovesiculectomy, and standardized prostate tissue sampling. Maximal standardized uptake values (SUVs) of 11C-choline within 36 segments of the prostate were determined. PET/CT results were correlated with histopathologic results, prostate-specific antigen (PSA), Gleason score, and pT stage. The SUV of 11C-choline in PCa tissue was 3.5 +/- 1.3 (mean +/- SD) and significantly higher than that in prostate tissue with benign histopathologic lesio...
Journal of Pharmacy and Pharmacology 7 (2017) 391-400, 2017
Purpose: The aim of this study was to determine whether PET (positron emission tomography) imaging parameters from simultaneous 11 C-choline PET/MRI (magnetic resonance imaging) could be used to characterize primary prostate cancer. Methods: Forty-six patients with biopsy-proven high-risk prostate cancer (clinical T stage ≥ cT2c, a Gleason score ≥ 8, or PSA (prostate-specific antigen) level > 20 ng/mL) were prospectively enrolled. A SUV (standardized uptake value) histogram analysis including maximum SUV, mean SUV, SUV variance, SUV entropy, MTV (metabolic tumor volume), and UVP (uptake volume product) was applied for the calculation of PET imaging parameters. Correlations between the PSA level and Gleason score were then evaluated. Results: Maximum SUV, mean SUV, MTV, UVP, and SUV variance were significantly correlated with PSA level, whereas SUV variance was the only parameter negatively correlated with the Gleason score. Multivariate logistic regression analysis demonstrated that MTV and PSA level at diagnosis were independent predictors of positive distant metastasis status. Conclusions: PET imaging parameters from simultaneous 11 C-choline PET/MRI were correlated with PSA level. However, 11 C-choline metabolic tumor heterogeneity was not associated with biospecimen-derived Gleason scores in prostate cancer. To apply PET texture quantification analysis to prostate cancer, a more specific PET radiotracer is required.
Kinetics of [ 11 C]choline uptake in prostate cancer: a PET stydy
European Journal of Nuclear Medicine and Molecular Imaging, 2004
Carbon-11 choline has recently been introduced as a potential tracer for tumour imaging with positron emission tomography (PET). We evaluated the kinetics of the uptake of [(11)C]choline in prostate cancer and benign prostatic hyperplasia. We also evaluated the association between the uptake of [(11)C]choline and the histological grade of malignancy, Gleason score, volume of the prostate and prostate-specific antigen (PSA). Fourteen patients with histologically confirmed prostate cancer and five patients with benign prostatic hyperplasia were studied with [(11)C]choline PET. A mean dose of 430+/-31 MBq of [(11)C]choline was injected intravenously and a dynamic emission acquisition of prostate was performed for 30 min. The uptake of [(11)C]choline was measured as a standardised uptake value (SUV) and as a kinetic influx constant ( K(i)) obtained from graphical analysis. Both cancerous and hyperplastic prostate were well visualised with [(11)C]choline against low or moderate tracer accumulation in the bladder and rectal wall. The measured radioactivity in urine was invariably low. In the graphical analysis, linear plots were achieved. The mean K(i) of the untreated tumour was 0.205+/-0.089 min(-1) (range 0.128-0.351; n=7) and the mean SUV was 5.6+/-3.2 (range 1.9-15.5; n=15). K(i) values and SUVs correlated closely ( r=0.964, P=0.0005), whereas no correlation could be demonstrated between the tumour uptake of [(11)C]choline and the histological grade, Gleason score, volume of the prostate or PSA. The mean SUV and the mean K(i) of benign hyperplastic prostate were 3.5+/-1.0 (range 2.0-4.5; n=4) and 0.119+/-0.076 min(-1) (range 0.065-0.173; n=2). In conclusion, a high uptake of [(11)C]choline characterises not only carcinomatous but also hyperplastic prostatic tissue. Dynamic imaging of the uptake of [(11)C]choline in the prostate shows a good applicability of the graphical analysis model with an irreversible compartment. A close correlation between the K(i) values and semiquantitative SUVs of tumours supports the use of the simpler SUV in the clinical setting.
2008
Purpose The accuracy of positron emission tomography (PET)/CT with [ 11 C]choline for the detection of prostate cancer is not well established. We assessed the dependence of [ 11 C]choline maximum standardized uptake values (SUV max ) in the prostate gland on cell malignancy, prostate-specific antigen (PSA) levels, Gleason score, tumour stage and anti-androgenic hormonal therapy. Methods In this prospective study, PET/CT with [ 11 C] choline was performed in 19 prostate cancer patients who subsequently underwent prostatectomy with histologic sextant analysis (group A) and in six prostate cancer patients before and after anti-androgenic hormonal therapy (bicalutamide 150 mg/day; median treatment of 4 months; group B). Results In group A, based on a sextant analysis with a [ 11 C]choline SUV max cutoff of 2.5 (as derived from a receiver-operating characteristic analysis), PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 72, 43, 64, 51 and 60%, respectively. In the patient-by-patient analysis, no significant correlation was detected between SUV max and PSA levels, Gleason score or pathological stage. On the contrary, a significant (P<0.05) negative correlation was detected between SUV max and anti-androgenic therapy both in univariate (r 2 =0.24) and multivariate (r 2 =0.48) analyses. Prostate [ 11 C]choline uptake after bicalutamide therapy significantly (P<0.05) decreased compared to baseline (6.4±4.6 and 11.8±5.3, respectively; group B). Conclusion PET/CT with [ 11 C]choline is not suitable for the initial diagnosis and local staging of prostate cancer. PET/CT with [ 11 C]choline could be used to monitor the response to anti-androgenic therapy.
Evaluation of Prostate Cancer with 11C- and 18F-Choline PET/CT: Diagnosis and Initial Staging
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2016
Early diagnosis and adequate staging are crucial for the choice of adequate treatment in prostate cancer (PC). Morphologic and functional imaging modalities, such as CT and MRI, have had limited accuracy in the diagnosis and nodal staging of PC. Molecular PET/CT imaging with (11)C- or (18)F-choline-labeled derivatives is increasingly being used, but its role in the diagnosis and initial staging of PC is controversial because of limitations in sensitivity and specificity for the detection of primary PC. For T staging, functional MRI is superior to (11)C- or (18)F-choline PET/CT. For N staging, (11)C- or (18)F-choline PET/CT can provide potentially useful information that may influence treatment planning. For the detection of bone metastases, (11)C- or (18)F-choline PET/CT has had promising results; however, in terms of cost-effectiveness, the routine use of (11)C- or (18)F-choline PET/CT is still debatable. (11)C- or (18)F-choline PET/CT might be used in high-risk PC before radiation...