The Application of l8F-Fluorodeoxyglucose Positron Emission Tomography in Assessment of Patients with Prostate Cancer after Initial Treatment

Objectives: There is a significant risk of prostate cancer recurrence after therapy. The aim of this study is to assess the use of 18F-fluorodeoxyglucose positron emission tomography (18p_pDG PET) in the detection of local recurrence and distant metastases after initial treatment of patients with prostate cancer. Material and Methods: Thirty patients with histologically proven prostatic adenocarcinoma were studied within 24 months (mean: 15 months) after their initial treatment. They were assessed by serum total prostate specific antigen (t- PSA), chest and abdomino-pelvic computerized tomography (CT), bone scintigraphy and 18F-FDG PET. Results: Local recurrence was diagnosed by pelvic CT and FDG-PET in 4/13 cases who had performed radical prostatectomy. Their mean standardized uptake value (SUV) calculated by FDG- PET was 3.1. This local recurrence was confirmed by pathological analysis of transrectal ultrasonography (TRUS) guided needle biopsies. Bone metastases were diagnosed by bone scintigraphy and FDG-PET in 18/30 patients, where their mean SUV was 5.6. While para aortic and/or pelvic lymph node metastases were diagnosed by abdomino-pelvic CT and FDG-PET in 10/30 cases with their mean SUV 4.7. The diagnosis of para aortic lymph node metastases was confirmed by the pathological analysis of abdominal CT guided needle biopsies in 3/10 cases. The metastases in the lung was diagnosed by chest CT and FDG- PET in 5/30 patients with their mean SUV 4.5. Conclusion: 18F-FDG PET can be applied to complement other conventional studies for diagnosis of local recurrence and distant metastases in patients with cancer prostate.