Detection of a second primary cancer in a 18F-fluorocholine PET/CT – multicentre retrospective analysis on a group of 1345 prostate cancer patients
, 2, 3, 4, 56, 78, 2, 39
Abstract
Background: Aim of this study was to evaluate the rate of incidental detection of second primary cancer (SPC) at 18F-fluorocholine ([18F]FCH) positron emission tomography/computed tomography (PET/CT) performed in prostate cancer patients. Material and methods: A retrospective analysis was performed on a group of 1345 prostate cancer patients, who underwent [18F]FCH PET/CT study because of suspicion of recurrence (n = 937) or for initial staging (n = 408). Images were acquired after intravenous injection [18F]FCH with a mean activity of 200 ± 75 MBq (5.4 ± 2 mCi), from the top of the head to the half of the thigh. The confirmation of second primary cancer was obtained from the cancer registry. Results: Based on the [18F]FCH PET/CT scans, a second primary cancer was suspected in 89 patients (6.6%). Of these, a malignancy was histologically confirmed in 26 patients (29% of all suspected findings and 1.9% of the complete cohort). Lung cancer (including adenocarcinoma, neuroendocrine cancer) was diagnosed in 13 patients (50%) and hematologic neoplasm (including chronic lymphocytic leukemia, Hodgkin lymphoma, follicular lymphoma, and multiple myeloma) in 5 patients (19%). 18F-fluorocholine PET/CT also revealed esophageal cancer, mesothelioma, testicular, renal, bladder, and colorectal cancer inindividual patients, non-keratinizing squamous cell carcinoma (SCC) of the skin as well as head and neck SCC with unknown primary. Conclusion: We conclude that incidental detection of a second primary cancer in prostate cancer patients using [18F]FCH PET/CT is not very common and that lung cancer and hematologic malignancies are most frequently detected.
Keywords: positron emission tomography/computed tomographyprostate cancersecond primary cancer
References
- Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
- Feller L, Lemmer J. New 'second primary' cancers. SADJ. 2012; 67(4): 175–178.
- Nielsen SF, Nordestgaard BG, Bojesen SE. Associations between first and second primary cancers: a population-based study. CMAJ. 2012; 184(1): E57–E69.
- Vali R, Loidl W, Pirich C, et al. Imaging of prostate cancer with PET/CT using (18)F-Fluorocholine. Am J Nucl Med Mol Imaging. 2015; 5(2): 96–108.
- Kwee SA, DeGrado TR, Talbot JN, et al. Cancer imaging with fluorine-18-labeled choline derivatives. Semin Nucl Med. 2007; 37(6): 420–428.
- Beheshti M, Haroon A, Bomanji JB, et al. Fluorocholine PET/computed tomography: physiologic uptake, benign findings, and pitfalls. PET Clin. 2014; 9(3): 299–306.
- Yoshimoto M, Waki A, Yonekura Y, et al. Characterization of acetate metabolism in tumor cells in relation to cell proliferation: acetate metabolism in tumor cells. Nucl Med Biol. 2001; 28(2): 117–122.
- Evangelista L, Cimitan M, Zattoni F, et al. Comparison between conventional imaging (abdominal-pelvic computed tomography and bone scan) and [(18)F]choline positron emission tomography/computed tomography imaging for the initial staging of patients with intermediate- tohigh-risk prostate cancer: A retrospective analysis. Scand J Urol. 2015; 49(5): 345–353.
- Fanti S, Minozzi S, Castellucci P, et al. PET/CT with (11)C-choline for evaluation of prostate cancer patients with biochemical recurrence: meta-analysis and critical review of available data. Eur J Nucl Med Mol Imaging. 2016; 43(1): 55–69.
- Picchio M, Messa C, Landoni C, et al. Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]fluorodeoxyglucose-positron emission tomography. J Urol. 2003; 169(4): 1337–1340.
- Gauvin S, Rompré-Brodeur A, Chaussé G, et al. F-fluorocholine positron emission tomography-computed tomography (F-FCH PET/CT) for staging of high-risk prostate cancer patients. Can Urol Assoc J. 2019; 13(4): 84–91.
- Warren S, Gates O. Multiple primary malignant tumors: A survey of the literature and statistical study. Am J Cancer. 1932; 16: 1358–1414.
- Chun-Sing W, Nan-Jie G, Yiu-Ching C. Prevalence of synchronous second primary malignancy: identification using whole body PET/CT imaging. Clin Imaging. 2014; 38(2): 179–186.
- Garcheva M, Zlatareva D, Gocheva L. Positron emission tomography combined with computed tomography for diagnosis of synchronous tumors. Klin Onkol. 2014; 27(4): 283–286.
- Moletta L, Bissoli S, Fantin A, et al. PET/CT incidental detection of second tumor in patients investigated for pancreatic neoplasms. BMC Cancer. 2018; 18(1): 531.
- Pang L, Liu G, Shi H, et al. Nineteen cases with synchronous multiple primary cancers studied by 18 F-FDG PET/CT. Hell J Nucl Med. 2017; 20(1): 36–40.
- Gunes BY, Akbayır O, Demirci E, et al. Clinical, pathological and (18)F-FDG PET/CT findings in synchronous primary vaginal and endometrial cancers. Hell J Nucl Med. 2016; 19(2): 170–172.
- Płachta M, Cholewiński W, Burchardt E, et al. Strategy and early results of treatment of advanced cervical cancer patients with synchronous cancers observed in PET-CT imaging. Ginekol Pol. 2017; 88(9): 475–480.
- Strobel K, Haerle SK, Stoeckli SJ, et al. Head and neck squamous cell carcinoma (HNSCC)--detection of synchronous primaries with (18)F-FDG-PET/CT. Eur J Nucl Med Mol Imaging. 2009; 36(6): 919–927.
- Miyazaki T, Sohda M, Higuchi T, et al. Effectiveness of FDG-PET in screening of synchronous cancer of other organs in patients with esophageal cancer. Anticancer Res. 2014; 34(1): 283–287.
- Amer MH. Multiple neoplasms, single primaries, and patient survival. Cancer Manag Res. 2014; 6: 119–134.
- How Kit N, Dugué AE, Sevin E, et al. Pairwise comparison of 18F-FDG and 18F-FCH PET/CT in prostate cancer patients with rising PSA and known or suspected second malignancy. Nucl Med Commun. 2016; 37(4): 348–355.
- García JR, Ponce A, Canales M, et al. [Detection of second tumors in 11C-choline PET/CT studies performed due to biochemical recurrence of prostate cancer]. Rev Esp Med Nucl Imagen Mol. 2014; 33(1): 28–31.
- Sollini M, Pasqualetti F, Perri M, et al. Detection of a second malignancy in prostate cancer patients by using [(18)F]Choline PET/CT: a case series. Cancer Imaging. 2016; 16(1): 27.
- Buroni FE, Persico MG, Lodola L, et al. Malignant Lymphoma Imaged by 18F-Fluoro-Choline PET-CT in a Patient with Prostate Cancer: a Case Report and Review of Literatureostate Cancer: A Case Report and Review of the Literature. STJ Cancer. 2017; 1(1002).
- Tuscano C, Russi EG, Al Sayyad S, et al. An Incidental Finding of Mucinous Colon Cancer by (18)F-Choline PET/CT Determining a Change in Clinical Management of a Patient with Recurrent Prostate Adenocarcinoma. Case Rep Oncol Med. 2014; 2014: 297031.
- Hodolic M, Huchet V, Balogova S, et al. Incidental uptake of (18)F-fluorocholine (FCH) in the head or in the neck of patients with prostate cancer. Radiol Oncol. 2014; 48(3): 228–234.
- Calabria F, Chiaravalloti A, Cicciò C, et al. PET/CT with 18 F-choline: Physiological whole bio-distribution in male and female subjects and diagnostic pitfalls on 1000 prostate cancer patients: 18 F-choline PET/CT bio-distribution and pitfalls. A southern Italian experience. Nucl Med Biol. 2017; 51: 40–54.
- Pieterman RM, Que TH, Elsinga PH, et al. Comparison of (11)C-choline and (18)F-FDG PET in primary diagnosis and staging of patients with thoracic cancer. J Nucl Med. 2002; 43(2): 167–172.
- Giovacchini G, Giovannini E, Leoncini R, et al. PET and PET/CT with radiolabeled choline in prostate cancer: a critical reappraisal of 20 years of clinical studies. Eur J Nucl Med Mol Imaging. 2017; 44(10): 1751–1776.
