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J Nucl Med. 2008; 49 (Supplement 1):373P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Does forced diuresis improve (18)F-fluoroethylcholine-PET interpretation in prostate cancer?

Christian Dueren1, Reinhard Lorenz1, Christoph Reiners1 and Michael Kreissl1

1 Nuclear Medicine, University Wuerzburg, Wuerzburg, Germany

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Objectives: Our aim was to evaluate the role of forced diuresis on image interpretation of FECH-PET for diagnostic work-up of prostate cancer.

Methods: We evaluated retrospectively 28 patients, mean age 65 ± 9 years, with untreated prostate cancer (n = 5), or increasing levels of prostate-specific antigen (PSA) after curative therapy (n = 23). 30 min. after injection of FECH a whole body PET scan was started with 6 bed positions, total scantime about 60 min. using a dedicated PET-Scanner (Siemens ECAT Exact 4). Then the patients were administered 20 mg furosemide i.v. and either infused with one litre of saline or instructed to drink one litre of fluid. 30-60 min. after furosemide injection, a second PET study of the pelvic region with only two bed positions was acquired. The PET data were analyzed with and without the knowledge of the postdiuretic study and classified as normal, equivocal and pathological. The visualization of the prostate in untreated patients and the extent of urinary tracer elimination from the urinary system was assessed.

Results: Forced diuresis eliminated FECH activity from the lower urinary tract in 26 (93%) patients and was well tolerated. Without diuresis 12 studies were classified as equivocal, 6 as pathological, 10 as normal, with diuresis 5 as equivocal, 9 normal and 14 as pathological. Diuresis led to an upstaging in 8 (29%) to a downstaging in 2 patients (7 %). 7 of 12 (58 %) equivocal lesions were classified differently, either normal (n =2) or pathological.

Conclusions: In our preliminary data forced diuresis changed the study interpretation in 36% of FECH-PET in patients with prostate cancer. Further prospective studies are necessary to assess the diagnostic accuracy of this method.





This Article
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Right arrow Articles by Dueren, C.
Right arrow Articles by Kreissl, M.