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Year : 2013  |  Volume : 12  |  Issue : 3  |  Page : 101-110

Kinetic Modeling Application to 18 F-fluoroethylcholine Positron Emission Tomography in Patients with Primary and Recurrent Prostate Cancer Using Two-tissue Compartmental Model

Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg; Department of Nuclear Medicine and Radiology, Knappschaft Hospital, 66280 Sulzbach, Germany

Correspondence Address:
Dr. Mustafa Takesh
University Heidelberg, Department of Nuclear Medicine, Im Neuenheimer Feld 400, 69120 Heidelberg
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1450-1147.136734

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Although 18 F-fludeoxyglucose-positron emission tomography (PET) is the most applied diagnostic method in tumor staging, its role in prostate cancer (PCA) is limited because glucose metabolism tends to be low unless PCA has high Gleason score. Alternatively, choline PET was introduced as a valuable imaging method. Kinetic analysis of PET acquisition has increasingly gained momentum as an investigative tool because it provides a non-invasive approach to obtain kinetic and metabolic data from tissues of interest including transport and metabolism of the administered material. In this regard, we sought to apply it in 18 F-fluoroethylcholine (FECH)-PET/computed tomography (CT) in patients with PCA. 64 patients, the mean age 69 (range: 47-87 years) with primary/recurrent PCA were encompassed. They underwent 18 F-FECH-PET started with a dynamic acquisition using a 20-frame each 30 s over the prostate region and followed at 1 h post-injection by a static whole body imaging. The kinetic evaluation of the data was performed using the software package PMOD (PMOD Technologies Ltd., Zürich, Switzerland). Significant increase in mean values for K1, K3, FD, standardized uptake value (SUV) and global influx in tumor tissue versus normal tissue (P < 0.05). Moderate but significant correlation (r: 0.28, P = 0.023) between SUV and K1. By contrast, no correlation between SUV and K3 (r: −0.08, P = 0.79). In patients with recurrent tumors, there is no significant difference in all kinetic parameters and SUV (P > 0.1) between the different types of recurrences. The kinetic analysis of dynamic FECH-PET provides a novel method in primary PCA diagnosis and could be of potential value in the delineation of tumor focus.

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