scholarly journals Evaluation of Bone Metastases by 18F-Choline PET/CT in a Patient with Castration-Resistant Prostate Cancer Treated with Radium-223

2016 ◽  
Vol 84 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Piera Scalzi ◽  
Cinzia Baiocco ◽  
Sabrina Genovese ◽  
Antonella Trevisan ◽  
Zuzana Sirotova ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Bone Metastases ◽  
Metabolic Response ◽  
Specific Antigen ◽  
Castration Resistant Prostate Cancer ◽  
Choline Pet ◽  
Castration Resistant ◽  
Radium 223 ◽  
Pet Ct

Background To date, bone metastases remain the main cause of morbidity and mortality in patients with metastatic castration-resistant prostate cancer (mCRPC). Therefore, the combination of accurate early detection of bony disease and effective treatment of these lesions is crucial in the management of mCRPC patients, but clinical trials specifically designed to test novel approaches are currently lacking. Case Description This report describes the case of a 74-year-old male with bone mCRPC and symptomatic and biochemical progression, who underwent radium-223 therapy, following previous treatment failure. 18F-choline positron emission tomography (PET)/computed tomography (CT) was used to assess changes in skeletal tumor activity before and after radium-223. Changes in prostate-specific antigen and alkaline phosphatase were also determined. 18F-choline PET/CT showed that treatment with radium-223 was able to effectively reduce bone metastatic disease, and this was accompanied by an excellent metabolic response. Conclusions In clinical practice, metabolic assessment of lesions by 18F-choline PET/CT following radium-223 seems a valid approach to monitor treatment response. Until results from clinical trials become available, reporting of single cases relating to data on the use of this technique remains paramount.

scholarly journals Accurate Monitoring of the Response of Bone Metastases to Treatment in Patients with Prostate Cancer Using Choline PET/CT

2021 ◽  
pp. 520-524
Author(s):  
Kazuhiro Kitajima ◽  
Shingo Yamamoto ◽  
Masayuki Fujiwara ◽  
Yusuke Kawanaka ◽  
Yusuke Yamada ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Metabolic Response ◽  
Choline Uptake ◽  
Castration Resistant Prostate Cancer ◽  
Choline Pet ◽  
Metastatic Lesions ◽  
Radium 223 ◽  
Positron Emission ◽  
Pet Ct

We here report 2 cases of castration-resistant prostate cancer (CRPC) observed two times on 11C-choline positron emission tomography computed tomography (PET/CT), which was useful to discriminate viable progressive osteoblastic bone metastasis from benign osteoblastic change induced by the treatment effect and to determine the viability of bone metastases, regardless of whether sclerosis was present or not. Because one case demonstrated disappearance of abnormal 11C-choline uptake of osteoblastic metastatic lesions after abiraterone therapy and no new lesions at other sites, suggesting nonviable bone metastases, we can assume a complete metabolic response. Because the other case demonstrated a decrease in the existing, abnormal 11C-choline uptake of osteoblastic metastatic lesions, but multiple new appearances of osteoblastic and nonosteoblastic lesions with abnormal 11C-choline uptake after radium-223 therapy suggesting multiple viable bone metastases, we can assume progressive metabolic disease. 11C-choline PET/CT could help in assessing the treatment response of bone metastases in patients with metastatic CRPC.

scholarly journals Prognostic Value of 18F-Choline PET/CT in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Radium-223

Biomedicines ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. 555
Author(s):  
Luca Filippi ◽  
Gian Paolo Spinelli ◽  
Agostino Chiaravalloti ◽  
Orazio Schillaci ◽  
Francesco Equitani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Emission Computed Tomography ◽  
Castration Resistant Prostate Cancer ◽  
Choline Pet ◽  
Castration Resistant ◽  
Kaplan Meier ◽  
Radium 223 ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Clinical Records

We aimed to investigate the role of positron emission computed tomography (PET/CT) with 18F-choline for predicting the outcome of metastatic castration-resistant prostate cancer (mCRPC) submitted to treatment with Radium-223 (223Ra-therapy). Clinical records of 20 mCRPC patients submitted to PET/CT with 18F-choline before 223Ra-therapy were retrospectively evaluated. The following PET-derived parameters were calculated: number of lesions, maximum and mean standardized uptake values (SUVmax, SUVmean), lean body mass corrected SUV peak (SULpeak), metabolic tumor volume (MATV), and total lesion activity (TLA). After 223Ra-therapy, all patients underwent regular follow-up until death. The predictive power of clinical and PET-derived parameters on overall survival (OS) was assessed by Kaplan–Meier analysis and the Cox proportional hazard method. All the patients showed 18F-choline-avid lesions at baseline PET/CT. Among the enrolled subjects, eleven (55%) completed all the six scheduled cycles of 223Ra-therapy; seven (35%) were responders according to imaging and biochemical parameters. Mean OS was 12.7 ± 1.4 months: by Kaplan–Meier analysis, number of lesions, PSA level and TLA were significantly correlated with OS. In multivariate Cox analysis, TLA remained the only significant predictor of survival (p = 0.003; hazard ratio = 7.6, 95% confidence interval = 1.9–29.5 months). 18F-choline PET may be useful for patients’ stratification before 223Ra-therapy. In particular, high metabolically active tumor burden (i.e., TLA) was predictive of poor outcome.

scholarly journals Assessment of the viability and treatment response of bone metastases in patients with metastatic castration-resistant prostate cancer using choline PET/CT

Medicine ◽  
2021 ◽  
Vol 100 (23) ◽  
pp. e26206
Author(s):  
Kazuhiro Kitajima ◽  
Shingo Yamamoto ◽  
Yusuke Kawanaka ◽  
Hisashi Komoto ◽  
Kimihiro Shimatani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Treatment Response ◽  
Castration Resistant Prostate Cancer ◽  
Choline Pet ◽  
Castration Resistant ◽  
Pet Ct

scholarly journals Metastasis-Directed Radiotherapy for Oligoprogressive Castration-Resistant Prostate Cancer Recurrence Revealed by Choline PET/CT

2021 ◽  
pp. 13-16
Author(s):  
Kazuhiro Kitajima ◽  
Shingo Yamamoto ◽  
Masayuki Fujiwara ◽  
Hitomi Suzuki ◽  
Nahomi Yoshimura ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Local Treatment ◽  
Specific Antigen ◽  
Cancer Recurrence ◽  
High Dose ◽  
Castration Resistant Prostate Cancer ◽  
Choline Pet ◽  
Castration Resistant ◽  
Pet Ct

We report a 49-year-old male with castration-resistant prostate cancer (CRPC) with oligometastasis diagnosed by <sup>11</sup>C-choline positron emission tomography-computed tomography (PET/CT) and treated with target radiotherapy. In the diagnosis of CRPC (serum prostate-specific antigen [PSA] level of 6.53 ng/mL after maximum androgen blockade (MAB) therapy, high-dose brachytherapy, and external beam radiotherapy), <sup>11</sup>C-choline PET/CT detected one tiny obturator lymph node metastasis which fluorodeoxyglucose PET/CT could not detect. He underwent intensity-modulated radiation therapy and MAB was restarted. The PSA value decreased and reached nadir (0.091 ng/mL) after 6 months. The time to PSA progression was 10 months. The choline PET/CT finding and the corresponding local treatment could play an important role in the management sequence of oligoprogressive CRPC.

Bone modifying agents in veterans with castration-resistant prostate cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6582-6582
Author(s):  
Jordan Bauman ◽  
Kyle Kumbier ◽  
Jennifer A. Burns ◽  
Jordan Sparks ◽  
Phoebe A. Tsao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Specific Antigen ◽  
Veterans Health ◽  
Health Administration ◽  
Castration Resistant Prostate Cancer ◽  
National Guidelines ◽  
Castration Resistant ◽  
Unit Increase

6582 Background: Skeletal related events (SREs) are a known complication for the 80% of men with metastatic prostate cancer who have bone metastases. Previous studies have demonstrated that bone modifying agents (BMAs) such as zoledronic acid and denosumab reduce SREs in men with metastatic castration-resistant prostate cancer who have bone metastases and are now recommended by national guidelines. We sought to investigate factors associated with use of BMAs in Veterans with CRPC across the Veterans Health Administration (VA). Methods: Using the VA Corporate Data Warehouse, consisting of aggregated medical record data from 130 facilities, we used an algorithm previously published to identify men with a diagnosis of castration-resistant prostate cancer (CRPC) based on rising prostate specific antigen (PSA) levels while on androgen deprivation therapy and who received systemic treatment for CRPC with one of the commonly used therapies: abiraterone, enzalutamide, docetaxel, ketoconazole between 2010 and 2017. To account for clustering among facilities, we used a multilevel multivariable logistic regression to determine the association of patient and disease-specific variables on the odds of a patient receiving a BMA after they started treatment for CRPC. Results: Of 4,998 patients with CRPC in our cohort, 2223 (44%) received either zoledronic acid or denosumab at some point after they were initiated on treatment for CRPC. After adjusting for other variables and accounting for a facility, the odds of receiving a BMA decreased by 3% for every additional year of age (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.96-0.98), and decreased significantly with increasing comorbid conditions (OR 0.94, 95% CI 0.72-0.98 for Charlson Comorbidity Index [CCI] of 1; OR 0.69, 95% CI 0.59-0.81 for CCI 2+). Patients who were Black had 25% lower odds of receiving a BMA than patients who were White (OR 0.75, 95% CI 0.65-0.87). PSA at time of CRPC treatment start had a small but not significant effect on receipt of a BMA (OR 1.04, 95% CI 1.00-1.08) for every unit increase of PSA on the log scale. PSA doubling time was not associated with receipt of a BMA. The presence of a diagnosis code for bone metastases was far lower than expected in this cohort of patients with CRPC (40.7%), and thus was not included in the model. We did not expect the presence of bone metastases to vary significantly among the other independent variables. Conclusions: Despite most patients with CRPC historically having bone metastases, less than half of patients with CRPC received a BMA. Patients who are older, had more comorbidities, or were Black were less likely to receive a BMA after starting treatment for CRPC. Understanding factors that lead to different patterns of treatment can guide initiatives toward more guideline-concordant care.

scholarly journals Re‐treatment with radium‐223: 2‐year follow‐up from an international, open‐label, phase 1/2 study in patients with castration‐resistant prostate cancer and bone metastases

The Prostate ◽  
2019 ◽  
Vol 79 (14) ◽  
pp. 1683-1691 ◽  
Author(s):  
Oliver Sartor ◽  
Daniel Heinrich ◽  
Neil Mariados ◽  
Maria José Méndez Vidal ◽  
Daniel Keizman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Phase 1 ◽  
Castration Resistant Prostate Cancer ◽  
Open Label ◽  
Castration Resistant ◽  
Radium 223 ◽  
Open Label Phase
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