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In biochemical recurrence after curative treatment of prostate cancer, Choline PET/CT

In biochemical recurrence after curative treatment of prostate cancer, Choline PET/CT 1- has a detection rate of 10-20% when PSA: 1-2 ng/ml 2- has a detection rate of 81% when PSA dt is less than 3 months 3- it best identifies patients with bone metastases

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In biochemical recurrence after curative treatment of prostate cancer, Choline PET/CT

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  1. In biochemical recurrence after curative treatment of prostate cancer, Choline PET/CT 1- has a detection rate of 10-20% when PSA: 1-2 ng/ml 2- has a detection rate of 81% when PSA dt is less than 3 months 3- it best identifies patients with bone metastases 4- PET/CT is indicated for pre-op staging in case of suspicious MRI

  2. 2-A negative Choline PET/CT • is not sufficient to rule out the indication for lymph-adenectomy • a-true • b-false

  3. A 67 year old man has a T2b prostate cancer Gleason score 8, PSA: 8.7ng/ml. mpMRI shows extracapsular extension on the right , no enlarged lymph nodes 1- a bone scan is necessary 2- bone scan is more accurate for osteoclastic lesions 3- mp MRI of the prostate can detect all bone metastases 4- DW total body MRI is more sensitive than bone scan to R/O bone metastases

  4. The use of choline PET/CT for preoperative LN staging: 1- is indicated 2- high sensitivity but poor specificity 3- should be limited to patients with very high risk for LN positive status according to nomograms 4- has a low positive predicted value

  5. PET choline for detection of LN and distant recurrence in PC patients with biochemical recurrence 1- Significantly high detection rate with PSA <1 ng/ml 2- The Trigger PSA value is = or > 5g/ml 3- No relationship between detection rate and PSA kinetics 4- A crucial role as first diagnostic procedure in patients who demonstrate a fast growing PSA kinetics and low Trigger PSA

  6. choline PET/CT 1- could play a crucial role as first diagnostic procedure in PC patients 2- It is not recommended for initial diagnosis and staging as a first-line method 3- PSA dt could not be considered as an independent predictor of positive choline PET/CT 4- 18f choline PET/CT is not accurate to detect distant recurrence

  7. DynamicContrastStudy • Based on density of tumor cells • Early enhancement of tumoral tissue in T2- weighted MRI • Delayed wash out of contrast agent are seen in prostate cancer • Early enhancement of tumoral tissue in T1 - weighted MRI

  8. Diffusion Weighted Imaging • Works based on angiogenesis • Water molecules movement increases in a high cellular environment • Sensitivity and specificity of DWI when added to T2-Weighted MRI for detecting prostate cancer is about 84% and 87% respectively • DW-MR imaging alone shows high sensitivity in cancer recurrence detection after radiotherapy

  9. MR Spectroscopy • Combination of choline and fluorocholine is measured in MRS • Citrate accumulates in the T zone • Citrate is higher in malignant prostatic tissue • A higher ratio of Cho+Cr/Ci (more than 0.75 ) is in favor of high risk of malignancy

  10. Regarding the use of MultiparametricMR imaging select the wrong answer • Detection and local staging of prostate cancer • Follow-up of patients after radical prostatectomy or radiation therapy • Detection of skeletal metastasis • Targeting biopsies in patients suspicious of prostate cancer

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