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Metastatic Prostate Cancer Proven by 18F-FCH PET/CT Staging Scan in Patient With Normal PSA but High PSA Doubling Time

Hodolič, Marina MD*; Maffione, Anna Margherita MD; Fettich, Jure MD*; Gubina, Borut MD; Cimitan, Marino MD§; Rubello, Domenico MD

doi: 10.1097/RLU.0b013e31829b9d6b
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A 59-year-old man presented with frequent urination. Six months ago, his prostate-specific antigen (PSA) was 1.56 ng/mL; currently it is 3.5 ng/mL (PSA doubling time = 6 months; PSA velocity = 0.19 ng/mL/mo). Biopsy revealed aggressive prostate cancer (Gleason score 5 + 5). Staging with 18F-fluorocholine PET/CT (18F-FCH PET/CT) demonstrated lymph node metastasis. After 6 months of hormonal therapy with goserelin, PSA decreased to 0.38 ng/mL. A 18F-FCH PET/CT restaging scan demonstrated a global reduction of 18F-FCH lesion uptake with disappearance of some mediastinal and iliac pelvic lymph node activity.

From the *Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; †Department of Nuclear Medicine, PET/CT Centre, Santa Maria della Misericordia Hospital Rovigo, Rovigo, Italy; ‡Department of Urology, University Medical Centre Ljubljana, Ljubljana, Slovenia; and §Department of Nuclear Medicine, National Cancer Institute CRO IRCCS, Aviano, Italy.

Received for publication January 9, 2013; revision accepted May 10, 2013.

Conflicts of interest and sources of funding: none declared.

M.H. and A.M.M. contributed equally to the manuscript.

Reprints: Anna Margherita Maffione, MD, Santa Maria della Misericordia Hospital Rovigo, Via Tre Martiri 140, 45100 Rovigo, Italy. E-mail:

© 2013 by Lippincott Williams & Wilkins