We present the first case of salvage retroperitoneal lymph node dissection based on the results of 18F-FACBC PET/CT performed for a prostate-specific antigen relapse after radical prostatectomy. The patients underwent 11C-choline PET/CT, which turned out negative, while 18F-FACBC PET/CT visualized two lymph node metastases confirmed at pathological examination. Preliminary clinical reports showed an improvement in the detection rate of 20-40% for 18F-FACBC in comparison with 11C-choline, rendering the 18F-FACBC the potential radiotracer of the future. Salvage surgery for prostate cancer is a fascinating but controversial approach. New diagnostic tools may improve its potential by increasing the assessment and the selection of the patients.

Keywords:
Prostate cancer, PET/CT, 11C-Choline, 18F-FACBC, Salvage retroperitoneal lymph node dissection, Biochemical relapse, Clinical relapse, Lymph node metastasis
1.
Pound CR, Partin AW, Eisenberger MA, et al: Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999;281:1591-1597.
2.
Farsad M, Schiavina R, Franceschelli A, et al: Positron-emission tomography in imaging and staging prostate cancer. Cancer Biomark 2008;4:277-284.
3.
Schiavina R, Martorana G: The promise of choline-PET/CT in the detection of recurrent prostate cancer: what are the limits of our investigation? Eur Urol 2012;63:797-799.
4.
Heesakkers RA, Jager GJ, Hövels AM, et al: Prostate cancer: detection of lymph node metastases outside the routine surgical area with ferumoxtran-10-enhanced MR imaging. Radiology 2009;251:408-410.
5.
Schuster DM, Savir-Baruch D, Nieh P, et al: Detection of recurrent prostate carcinoma with anti-3-18F-fluorocyclobutane-1-carboxylic acid PET/CT and 111In-capromab pendetide SPECT/CT. Radiology 2011;259:852-861.
6.
Nanni C, Schiavina R, Boschi S, et al: Comparison of 18F-FACBC and 11C-choline PET/CT in patients with radically treated prostate cancer and biochemical relapse: preliminary results. Eur J Nucl Med Mol Imaging 2013;40(suppl 1):S11-S17.
7.
Rigatti P, Suardi N, Briganti A, et al: Pelvic/retroperitoneal salvage lymph node dissection for patients treated with radical prostatectomy with biochemical recurrence and nodal recurrence detected by [11C]choline positron emission tomography/computed tomography. Eur Urol 2011;60:935-943.
8.
Jilg CA, Rischke HC, Reske SN, Henne K, Grosu AL, Weber W, Drendel V, Schwardt M, Jandausch A, Schultze-Seemann W: Salvage lymph node dissection with adjuvant radiotherapy for nodal recurrence of prostate cancer. J Urol 2012;188:2190-2197.
9.
Schuster DM, Votaw JR, et al: Initial experience with the radiotracer anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid with PET/CT in prostate carcinoma. J Nucl Med 2007;48:56-63.
10.
Martorana G, Schiavina R, Franceschelli A: Should we perform imaging-guided lymph node dissection in patients with lymphatic recurrence of prostate cancer after radical prostatectomy? Eur Urol 2009;55:1302-1304.
11.
Brunocilla E, Pernetti R, Martorana G: The role of pelvic lymph node dissection during radical cystectomy for bladder cancer. Anticancer Res 2011;31:271-275.
© 2013 S. Karger AG, Basel
2013
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