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First case of 18F-FACBC PET/CT-guided salvage radiotherapy for local relapse after radical prostatectomy with negative 11C-Choline PET/CT and multiparametric MRI: New imaging techniques may improve patient selection

Eugenio Brunocilla, Riccardo Schiavina, Cristina Nanni, Marco Borghesi, Matteo Cevenini, Enrico Molinaroli, Valerio Vagnoni, Paolo Castellucci, Francesco Ceci, Stefano Fanti, Caterina Gaudiano, Rita Golfieri, Giuseppe Martorana
  • Eugenio Brunocilla
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Riccardo Schiavina
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy | rschiavina@yahoo.it
  • Cristina Nanni
    Department of Nuclear Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Marco Borghesi
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Matteo Cevenini
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Enrico Molinaroli
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Valerio Vagnoni
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Paolo Castellucci
    Department of Nuclear Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Francesco Ceci
    Department of Nuclear Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Stefano Fanti
    Department of Nuclear Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Caterina Gaudiano
    Department of Radiology, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Rita Golfieri
    Department of Radiology, S. Orsola-Malpighi Hospital, Bologna, Italy
  • Giuseppe Martorana
    Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy

Abstract

We present the first case of salvage radiotherapy based on the results of 18F-FACBC PET/CT performed for a PSA relapse after radical prostatectomy. The patients underwent 11CCholine PET/CT and multiparametric MRI that were negative while 18F-FACBC PET/CT visualized a suspected local relapse confirmed by transrectal ultrasound-guided biopsy. No distant relapse was detected. Thus the patient was submitted to salvage radiotherapy in the prostatic fossa. After 20 months of follow-up, the PSA was undetectable and 18F-FACBC PET/CT was negative. Salvage radiotherapy after surgery, provided that it is administered at the earliest evidence of the biochemical relapse, may improve cancer control and favourably influence the course of disease as well as the adjuvant approach. New imaging techniques may increase the efficacy of the salvage radiotherapy thus helping in the selection of the patients. Preliminary clinical reports showed an improvement in the detection rate of 20-40% of 18F-FACBC in comparison with 11C-Choline for the detection of disease relapse after radical prostatecomy, rendering the 18F-FACBC the potential radiotracer of the future for prostate cancer.

Keywords

Prostate cancer; PET/CT; 11C-Choline; 18FFACBC; Salvage radiotherapy; Biochemical relapse; Local relapse

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Submitted: 2014-10-10 11:53:42
Published: 2014-09-30 00:00:00
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Copyright (c) 2014 Eugenio Brunocilla, Riccardo Schiavina, Cristina Nanni, Marco Borghesi, Matteo Cevenini, Enrico Molinaroli, Valerio Vagnoni, Paolo Castellucci, Francesco Ceci, Stefano Fanti, Caterina Gaudiano, Rita Golfieri, Giuseppe Martorana

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