| The role of choline positron emission tomography/computed tomography in the management of patients with prostate-specific antigen progression after radical treatment of prostate cancer. | |
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MedLine Citation:
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PMID: 20869161 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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CONTEXT: Choline positron emission tomography (PET)/computed tomography (CT) is a currently used diagnostic tool in restaging prostate cancer (PCa) patients with increasing prostate-specific antigen (PSA) after either radical prostatectomy (RP) or external-beam radiation therapy (EBRT). However, no final recommendations have been made on the use of this modality for patient management. OBJECTIVE: To critically analyse the current evidence for the use of choline PET/CT scanning in the management of patients with a progressive increase in PSA after radical treatment for PCa, evaluating its diagnostic accuracy in the detection of recurrences, the clinical predictors of positive PET/CT examinations, and the modalities' role as a guide for tailored therapeutic strategies. EVIDENCE ACQUISITION: Data on recently published (2003-2010) original articles, review articles, and editorials concerning the role of choline PET/CT in this scenario were analysed. EVIDENCE SYNTHESIS: The diagnostic accuracy of choline PET in detecting sites of PCa relapse has been investigated by several authors, and the overall reported sensitivity ranges between 38% and 98%. It has been demonstrated that choline PET technology's positive detection rate improves with increasing PSA values. The routine use of choline PET/CT cannot be recommended for PSA values <1ng/ml. However, in addition to PSA serum value, PSA doubling time (PSA DT), and other clinical and pathologic features-including locally advanced tumour (pT3b-T4) or lymph node involvement at initial staging-should be considered to refer patients to choline PET/CT study. Choline PET/CT may be also proposed as a image guide either for experimental surgical or radiation therapy treatments. CONCLUSIONS: According to the current available data, choline PET/CT plays a role in the management of biochemical relapse. Its accuracy is correlated to PSA value, PSA DT, and other pathologic features. Choline PET/CT may be proposed as a guide for individualised treatment of recurrence. |
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Authors:
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Maria Picchio; Alberto Briganti; Stefano Fanti; Axel Heidenreich; Bernd J Krause; Cristina Messa; Francesco Montorsi; Sven N Reske; George N Thalmann |
Publication Detail:
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Type: Journal Article Date: 2010-09-15 |
Journal Detail:
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Title: European urology Volume: 59 ISSN: 1873-7560 ISO Abbreviation: Eur. Urol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-03-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7512719 Medline TA: Eur Urol Country: Switzerland |
Other Details:
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Languages: eng Pagination: 51-60 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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Department of Nuclear Medicine, San Raffaele Scientific Institute, Milan; Institute for Bioimaging and Molecular Physiology, National Research Council (IBFM-CNR), Milan, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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