The Effectiveness of 18F-Fluorocholine PET in Detecting, Staging and Following-up Prostate Cancer

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Project title/計畫英文名

Project Number/計畫編號

NSC100-2314-B002-155

Translated Name/計畫中文名

以18F-Fluorocholine正子造影運用於攝護腺癌偵測、分期及復發追蹤

Project Principal Investigator/計畫主持人

RUOH-FANG YEN

Funding Organization

National Science and Technology Council

Co-Investigator(s)/共同執行人

蒲永孝,成佳憲,梁博欽,余宏政

Website

link

Start date/計畫起

01-08-2011

Expected Completion/計畫迄

12-07-2012

摘要：攝護腺癌是台灣男性癌症死因的第七位，在2009 年就有將近1000 位台灣男性因攝護腺癌而死亡。傳統影像技術, 包括MRI 及 18F-FDG PET 在診斷攝護腺癌都有其限制性, 往往無法正確診斷/偵測原發、復發或轉移攝護腺癌病灶。膽鹼 (choline) 是磷脂醯膽鹼(phosphatidylcholine) 的主要成份，這些磷脂質又是細胞膜的重要成份。攝護腺癌細胞內膽鹼激脢(choline kinase) 較正常或肥大的攝護腺細胞增加相當大的數量，因為攝護腺癌細胞會將膽鹼合成磷脂醯膽鹼及磷脂質來促進加速細胞的複製。過去研究顯示11C-choline PET 可以偵測定位原發、復發或轉移攝護腺癌病灶。但是11C 的半衰期只有20 分鐘，往往尚未達到攝取平衡點時藥物就已衰變至無法影像，且半衰期短, 無法供應沒有迴旋加速器及正子藥物合成的正子中心使用。所以現在國外紛紛改發展以18F 來標識的正子藥物。18F-fluorocholine (18F-FCH) 正是目前國外正在開始發展的新興正子藥物之一。若18F-FCH 正子掃描能幫助臨床早期診斷並精確定位攝護腺癌病灶，對攝護腺癌患者後續治療計劃及預後將有重大影響力。本院迴旋加速器暨製藥中心已有能力製備18F-FCH。因此本院由泌尿部、腫瘤醫學部、影像醫學部及核子醫學部組成之攝護腺癌團隊計劃本為期三年的研究，以18F-FCH 正子造影來研究(1) 良性攝護腺肥大及攝護腺癌的區分，(2) 攝護腺癌的分期，(3) 攝攝護腺癌治療後復發病灶的早期偵測。
Abstract: Background and objectives:Prostate cancer is the 7th leading cause of cancer death for male in Taiwan.Conventional imaging techniques, including MRI and 18F-FDG PET are not sensitiveor specific enough to detect metastatic or recurrent disease. Choline is one of thecomponents of phosphatidylcholine, an essential element of phospholipids in the cellmembrane. Some malignant cells (especially prostate cancer cells) show their abilityto actively incorporate choline to produce phosphocholine and phosphatidylcholineto facilitate tumor cell duplication. 18F-fluorocholine has been shown to have theability to localize primary or metastatic prostate cancer. This study will be conductedto delineate the effectiveness of 18F-fluorocholine (FCH) in (1) differentiating benignprostate hypertrophy (BPH) from prostate cancer, (2) staging prostate cancer, (3)following-up patients with prostate cancer after initial curative therapy.Methods:In this study, 50 patients with benign prostate hyperplasia, 50 patients with newlydiagnosed prostate cancer, and 50 patients who have received curative treatment forprostate cancer but are suspicious of recurrences/metastases will be included in thestudy. Each patient will receive 18F-FCH PET study. PET imaging will be interpretedboth qualitatively (visual interpretation) and quantitatively (SUV, retention index).Comparisons between SUVs of BPH, those of prostate cancer will be performed,the optimal cutoff values of SUV in predicting prostate cancer will be determined, andthe accuracy of the 18F-FCH for detecting recurrent/metastatic prostate cancerlesions for each patient will be evaluated according to the patient’s finalhistopathology, further imaging and clinical follow-up results.Expected AchievementsTo establish1. a good cooperative team of prostate cancer, including urologists, radiologistsand nuclear medicine physicians2. standard procedure of 18F-FCH production and quality control3. standard imaging acquisition protocol of 18F-FCH PET4. criteria of 18F-FCH imaging interpretation5. clinical guideline of 18F-FCH PET in patients with primary or recurrentprostate cancer.

Keyword(s)

攝護腺癌
氟-18-膽鹼
正子造影
復發
轉移
prostate cancer
18F-fluorocholine
PET
recurrence
metastases

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The Effectiveness of 18F-Fluorocholine PET in Detecting, Staging and Following-up Prostate Cancer

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