Altered choline metabolism has been demonstrated in prostate cancer [1]. Choline analogues have been studied in the last decade and have been shown to be superior to conventional imaging modalities in the detection of loco-regional or distant metastatic disease in prostate cancer. In a recent meta-analysis investigating Choline PET-CT in the setting of biochemical failure and incorporating 53 studies from 2000 - 2012, Choline PET-CT had a pooled sensitivity of 86% and specificity of 93% for all sites of disease [2]. To date, there is...

This was a longitudinal observational pilot study of 34 patients who received Choline PET-CT scans with biochemical relapse after radical prostatectomy.Biochemical failure was defined as a PSA value of > 0.2ng/mL after radical prostatectomy [3]. Inclusion criteria: Histologically confirmed prostate cancer treated definitively with radical prostatectomy Patients with biochemical relapse (PSA >0.2ng/mL) In the setting of initial or subsequent relapse following local salvage therapy and/or androgren deprivation therapy (ADT) Exclusion criteria: Patients on current ADT or chemotherapy Medical contraindications to PET-CT (ie. claustrophobia, unable to...

Choline PET-CT was positive in 38.2% (13/34) of patients and negative in 61.7% (21/34). The 13 positive results were analysed by locations: None had recurrent disease in the prostate bed, 10 patients (76.9%) had regional node recurrence, 5 patients (38.4%) had bony metastatic, 3 patients (23%) had non regional node recurrence and 1 patient (7.6%) had distant soft tissue metastases. Figure [1] Analysis of patient's treatment history and PET-CT outcomes demonstrated that use of ADT prior to PET-CT resulted in more positive scans, 11 (73.3%)...

Choline PET-CT appears to be a useful tool for restaging patients with biochemical relapse, with modest detection rates. Our study suggests that Choline PET-CT is more likely to detect disease in patients with shorter PSA DT, higher peak PSA, and higher total Gleson score. ADT usage prior to Choline PET-CT is a strong predictor of positive PET-CT (p <0.01). From our study, we could see the potential of Choline PET-CT as a diagnotic imaging modality enabling the correct identification of localised from systemic disease and...

Role of funding source: Cancer and Palliative Care Research and Evaluation Unit (CaPCREU) (Project Application ID SGC 13/18), The University of Western Australia Acknowledgements: We would like to acknowledge the contribution of Penny Maton, Senior PET technologist, for setting up the imaging protocols and collating our patients' images for analysis, and to thank the Western Australia PET Service and Cyclotron staff for their assistance in this study.

Bauman G, Belhocine T, Kovacs M, Ward A, Beheshti M, Rachinsky I. 18F-fluorocholine for prostate cancer imaging: a systematic review of the literature. Prostate cancer and prostatic diseases. 2012;15(1):45-55. Evangelista L, Zattoni F, Guttilla A, Saladini G, Zattoni F, Colletti PM, et al. Choline PET or PET/CT and biochemical relapse of prostate cancer: a systematic review and meta-analysis. Clinical nuclear medicine. 2013;38(5):305-14. Nielsen ME, Partin AW. The impact of definitions of failure on the interpretation of biochemical recurrence following treatment of clinically localized prostate cancer....