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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Relationship between prostate-specific antigen kinetics and detection rate of radiolabelled choline PET/CT in restaging prostate cancer patients: a meta-analysis

Giorgio Treglia1 / Luca Ceriani1 / Ramin Sadeghi2 / Giampiero Giovacchini3 / 1

1Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

2Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3Department of Nuclear Medicine and Radio-Oncology, Stadtspital Triemli, Zurich, Switzerland

Corresponding author: Luca Giovanella, PD, MD, Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Via Ospedale, 12, 6500, Bellinzona, Switzerland, Phone: +41 9181186 72, Fax +41 918118250, E-mail:

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 52, Issue 5, Pages 725–733, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/cclm-2013-0675, December 2013

Publication History

Received:
2013-08-21
Accepted:
2013-11-04
Published Online:
2013-12-05

Abstract

Background: The aim of the article was to systematically review published data about the relationship between prostate-specific antigen (PSA) kinetics, including PSA doubling time (PSAdt) and PSA velocity (PSAvel), and detection rate (DR) of positron emission tomography/computed tomography (PET/CT) using radiolabelled choline in restaging prostate cancer (PCa).

Methods: A comprehensive literature search of studies published through July 2013 regarding the relationship between PSA kinetics and DR of radiolabelled choline PET/CT was carried out. Furthermore, a meta-analysis was performed in order to establish the DR of radiolabelled choline PET/CT using different cut-off values of PSAdt (≤ or >6 months) and PSAvel [>1 or ≤1 ng/(mL year) and >2 or ≤2 ng/(mL year)]. Moreover, a pooled analysis to establish whether PSAdt and PSAvel (using the abovementioned cut-off values) may predict positive PET/CT results was carried out.

Results: Fourteen articles were selected. The pooled DR of radiolabelled choline PET/CT in restaging PCa was 58% [95% confidence interval (CI) 55–60]. Most articles reported a relationship between PSA kinetics and DR of PET/CT. Pooled DR of radiolabelled choline PET/CT increased to 65% (95% CI 58–71) when PSAdt was ≤6 months and to 71% (95% CI 66–76) and 77% (95% CI 71–82) when PSAvel was >1 or >2 ng/(mL year), respectively. PSAdt ≤6 months and PSAvel >1 or >2 ng/(mL year) proved to be relevant factors in predicting the positive result of radiolabelled choline PET/CT.

Conclusions: Due to the strong relationship between PSA kinetics and DR of radiolabelled choline PET/CT, beyond PSA values, PSAdt and PSAvel should be taken into account in the selection of PCa patients who should undergo radiolabelled choline PET/CT for restaging.

Keywords: choline; positron emission tomography; prostate cancer; prostate-specific antigen (PSA); PSA kinetics

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