Metastatic spreading to the lungs is a negative prognostic factor in patients with prostate cancer (PC). Aim of our study was to assess the prevalence of lung PC metastases in patients with fluorine-18 fluoroethyl-choline (F-18-FECh) PET-CT positive lung lesions and the role of Gleason Score (GS) and common biochemical markers in predicting metastatic spreading to the lungs.
We retrospectively evaluated the scans of 1283 patients ongoing (F-18-FECh) PET-CT for PC between May 2010 and July 2014. Patients with lung lesion with F-18-FECh uptake were included. Data concerning GS at diagnosis, "trigger" prostate-specific antigen (PSAtr), PSA doubling time (PSAdt), PSA velocity (PSAvel) and ongoing androgen deprivation therapy were collected. PET-CT findings were confirmed by histology or followup (FU) and classified as follows: inflammation, primary lung cancer or metastases from tumour other than PC, and lung metastases from PC.
Twenty-two patients with F-18-FECh positive lung lesion and available histology or FU were identified. PSAdt was significantly (p=0.029) shorter in patients with lung metastases from PC (median PSAdt 1.7 months, interquartile range [IQR] 1.5-4.1 months) than in patients without lung PC relapse (median PSAdt 6.7 months, IQR 3.9-7.8); PSAvel was significantly (p=0.019) higher in patients with lung metastases from PC (median PSAvel 3.2 ng/ml/month, IQR 0.65-6.65 ng/ml/month) than in patients without lung PCrelapse (median PSAvel 0.3 ng/ml/month, IQR 0.2-0.5 ng/ml/month). Patients with lung metastases from PC had significantly (p=0.006) higher GS at diagnosis (median GS 8) than the other ones (median GS 7).
Our analysis shows that the prevalence of F-18-FECh positive lung metastases in patients with PC, especially with higher GS at diagnosis, is higher in presence of a steady increase in PSA values, confirmed by higher PSAvel and shorter PSAdt.
The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of.... 2018 Jan 17 [Epub ahead of print]
Daniele A Pizzuto, Salvatore Annunziata, Francesco P Ieria, Carmelo Caldarella, Maria A Isgrò, Valerio Lanni, Gaia Bencivenga, Vittoria Rufini, Alessandro Giordano
Institute of Nuclear Medicine, "Università Cattolica del Sacro Cuore "A. Gemelli", Rome, Italy - ., Institute of Nuclear Medicine, "Università Cattolica del Sacro Cuore "A. Gemelli", Rome, Italy., Nuclear Medicine Unit, Policlinico "A. Gemelli", Rome, Italy., Laboratorio Analisi Chimico-Cliniche ed Ematologiche, Ospedale di Circolo e Fondazione Macchi, Varese, Italy., PET-CT Center, Policlinico "A. Gemelli", Rome, Italy.