Appropriateness of prescription of 18F-Choline PET/CT in 100 consecutive patients with prostate cancer.

2629 Objectives To evaluate the appropriateness of prescription of 18F-Choline PET/CT (18FCH) in prostate cancer (PC) patients on a single PET/CT centre Methods We have evaluated data of 100 consecutive patients with PC (mean age: 74 years; range: 56-90), who were referred to our centre to perform 18FCH PET/CT (mean PSA: 13.99 ng/ml; range 0.01-319 ng/ml). As reference criteria to establish the appropriateness of the examination we used the indications for 18F-CH PET/CT as proposed by 1) the 2015 guidelines of the European Association of Urology (EAU) and the European Society of Medical Oncology (ESMO), 2) a recently published meta-analysis including 19 original papers on 18FCH PET/CT performed in a total of 1555 patients and 3) our regional PC unit procedural guidelines (Veneto, Italy). In agreement with the previous mentioned guidelines, 18FCH PET/CT was considered appropriate 1) in the staging of patients with intermediate or high risk PC; 2) in the restaging of patients with biochemical PC relapse (a: trigger PSA>1 ng/ml or b: PSA 1 ng/mL/year and PSAdt <3 months) and 3) in monitoring systemic therapy Results The overall Detection Rate (DR) 18FCH PET/CT was 65%. In both univariate and multivariate logistic regression analysis, trigger PSA was significantly correlated to DR of 18FCH PET (p<0.05). Moreover, 57% of the patients performed 18FCH PET/CT for restaging (mean PSA 4,74 ng/ml, DR: 53%), 24% for staging (mean PSA 14 ng/ml, DR: 100%) and 19% for monitoring the systemic treatment (mean PSA 25,69 ng/ml, DR: 58%). The overall appropriateness of prescription of 18FCH PET/CT was 86%; in particular, 85% in the restaging group, 100% in the staging group and 68% in the monitoring the systemic treatment group. Conclusions in our centre the prescription of 18FCH PET/CT resulted appropriated in the 86% of the cases which can be considered a good reference. Guidelines of the nuclear medicine communities on Choline PET/CT have not yet been published and are mandatory in order to have precise indications and perform appropriate Choline PET/CT examinations that can help the management of PC patients