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


Submitted: October 10, 2014
Accepted: October 10, 2014
Published: September 30, 2014
Abstract Views: 2071
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SUPPLEMENTARY MATERIAL: 349
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Authors

  • 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.
  • 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.
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.

Brunocilla, E., Schiavina, R., Nanni, C., Borghesi, M., Cevenini, M., Molinaroli, E., Vagnoni, V., Castellucci, P., Ceci, F., Fanti, S., Gaudiano, C., Golfieri, R., & Martorana, G. (2014). 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. Archivio Italiano Di Urologia E Andrologia, 86(3), 239–240. https://doi.org/10.4081/aiua.2014.3.239

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