A rapid and efficient F-choline PET/CT protocol used in a clinical routine practice in prostate cancer

36 Objectives We describe an easy and fast F18- Choline Protocol Positron Emission Tomography in Prostate Cancer using multiple acquisitions with Time Of Flight PET. We will present some clinical cases in 2 indications: First, at initial staging of Prostate Cancer with PSA>20 (conventional imaging negative) when curative traitement is schudeled. Second at rising PSA >0,5ng after treatment when conventional imaging remains negative. Methods Device used: PET/CT Time Of Flight,mCT 40 Siemens Patient preparation: patient was perfused with saline IV. Protocol: 1- Patient was installed lying on the table, dorsal decubitus, arms up. 2- Scout view and low dose CT (50mAs) was performed fisrt, from the knees to neck for attenuation correction purpose and anatomical localization 3- Injection of 2mBq/kg of F-Choline follow by intensive fluch injection to avoid accumumation of tracer in the arms and scapula vessels. 4- Starting first PET acquisition 30 seconds after injection of tracer, rapid acquisition (2mn/bed position) centered on pelvis, 8cm below ishiatic bone to fifth lumbar vertebra. 5- Second (delayed) acquisition from knees to neck using 5 to 7 bed positions (2mn/bed position). Results Total procedure is done in approximately 20 minutes allowing a flow of 2 pts/hours. First acquisition, 30s after injection allowing an accurate visualisation of prostate area, seminal vesicles and retrovesical space without tracer activity in the bladder. Second acquisition help us to confirm pathological accumulation of FCh in prostate gland or area of prostatectomy, and also for seminal vesicles; to confirm or invalidate pathological uptake in pelvic lymph nodes. These second “whole body” PET allow to diagnose associated bone lesion and less frequently lung disease. This fast protocol seems to be cost effective since FCh is more expensive than FDG. Conclusions From our first clinical experience, among more than 150 pts, this F-Choline PET/CT protocol seems to be clinically accurate and cost effective