Combined bone scintigraphy and fluorocholine PET/computed tomography predicts response to radium-223 therapy in patients with prostate cancer

Future Sci OA. 2021 May 21;7(8):FSO719. doi: 10.2144/fsoa-2021-0053. eCollection 2021 Sep.


Aim: To assess the value of bone scintigraphy and 18F-fluorocholine PET/computed tomography (CT) in predicting outcome in patients with prostate cancer and bone metastases treated with 223radium.

Materials & methods: Retrospective analysis of 48 patients that underwent 223radium therapy. End points were pain relief and overall survival.

Results: After therapy, pain relief was observed in 27 patients. Patients without pain relief had more bone lesions at PET/CT than at bone scintigraphy (pretherapy imaging mismatch). In 39 patients who completed treatment protocol, post-therapy alkaline phosphatase and pretherapy imaging mismatch were independent predictors of poor overall survival.

Conclusion: Patients with more lesions at 18F-fluorocholine PET/CT than at bone scintigraphy had a poor prognosis. The combined imaging approach could be useful to predict outcome after 223radium therapy.

Keywords: 18F-fluorocholine PET/CT outcome; 223radium; bone scintigraphy; prostate cancer.