Choline-C11 PET/CT scans can identify the actual sites of recurrence of prostate cancer in men who have a rising PSA after receiving primary therapy. The question worth asking is if this type of scan might be able to be used for prognostic purposes. Knowing this might influence our treatment decisions as well as our basic life decisions.

A retrospective analysis was performed of data from almost 200 men who had a radical prostatectomy as their primary prostate cancer treatment and who then received a choline PET/CT after a biochemical failure (PSA rising to a level greater than 0.2 mg/ml) while on treatment with androgen-deprivation therapy (ADT) showed that there were three measures that provided a statistical significance. They were:

Choline uptake
A Gleason score greater than 7.

The authors concluded that C-choline PET/CT is a measure, along with PSA and Gleason grade, that does predict prostate cancer specific survival in men treated with radical prostatectomy who develop biochemical failure during androgen-deprivation therapy.

Joel T. Nowak, M.A., M.S.W.