THE EFFECTIVENESS OF ¹¹C-CHOLINE POSITRON EMISSION TOMOGRAPHY IN THE DIAGNOSIS OF PROSTATE CANCER RECURRENCE AFTER RADIOTHERAPY

THE AIM of this study is to evaluate the effectiveness and informative value ¹¹C-choline positron emission tomography (PET) in diagnosis of local recurrence of prostate cancer (PC) in patients after radiotherapy. PATIENTS AND METHODS. The research is based on the results of the survey and treatment of 52 patients examined in the clinic Urology Medical Center, University of Groningen (Netherlands) following radiotherapy at the hystologicaly confirmed prostate cancer. The comparison was made between the clinical and morphological parameters in patients with signs of local recurrence after radiotherapy of prostate cancer detected by PET, with hystopatomorfologicheskimi results of a biopsy of the prostate. RESULTS. According to PET, local recurrence was diagnosed in 42 patients: in 15 (36%) patients – a single focus of recurrent tumor, in 27 (64%) – «scattered» hot spots. This coincidence PET findings with the results of prostate biopsy in the diagnosis of recurrence occurred in 32 (76%) patients. Of the remaining 10 patients: three patients had distant metastases according to PET, confirmed by the results of computed tomography and bone scintigraphy, two of the patients had hormone therapy in connection with rapidly progressive disease, five patients underwent local cryotherapy, were was observed reduction in prostate antigen (PSA) in blood plasma. In general, using PET morphologically confirmed local recurrence of prostate cancer was detected in 37 out of 42 (88%) patients. The coincidence of the results of PET and biopsy results with regard to the localization of recurrence was noted in 7 of 15 (47%) patients who had revealed a unilateral (one share of the prostate), prostate cancer recurrence, and in 11 out of 27 (41%) – with bilateral neoplastic process ( in both lobes). CONCLUSION. Application of ¹¹C-choline PET in most cases to identify local recurrence of prostate cancer patients undergoing radiotherapy. However, the accuracy of this method in determining the prevalence of foci of recurrent tumors of prostate cancer is insufficient reliable data can be obtained only by using a biopsy of the prostate.

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