A new article just published on line in the Journal of Urology offers additional information about the “operational characteristics” of [11C]choline PET/CT scanning in the diagnosis of biochemically recurrent prostate cancer after first-line treatment (a technique currently available only at the Mayo Clinic in Rochester, MN).
According to this article by Mitchell et al., based on a retrospective review of data from all 176 patients with recurrent disease who underwent [11C]choline PET/CT scanning at the Mayo Clinic between September 2007 and November 2010:
- 56/176 men (32 percent) had clinically useful [11C]choline PET/CT scans (implying that the scans were able to define prostate cancer lesions that were not identifiable with conventional forms of imaging and that lead to changes in the patients’ clinical management)
- The optimal value of a patient’s PSA at the time of lesion detection was 2.0 ng/ml.
- Two data points were significant predictors of a positive [11C]choline PET/CT scan result:
- The patient’s PSA at the time of the PET/CT scan (hazard ratio [HR] = 1.37; p = 0.04)
- The patient’s clinical stage at the time of his initial diagnosis of prostate cancer (HR = 5.19; p = 0.0035)
- A patient-based analysis of [11C]choline PET/CT data showed that this scan had
- A sensitivity of 93 percent
- A specificity of 76 percent
- A positive predictive value (PPV) of 91 percent
- A negative predictive value (NPV) of 81 percent
The authors conclude that [11C]choline PET/CT scanning “performs well” as an imaging test to identify the presence of prostate cancer lesions in men with biochemical recurrence following primary treatment failure.