PET/CT for the diagnosis, staging and restaging of prostate cancer

Prostate cancer is one of the most frequent cancers in men and constitutes the third most common cause of cancer deaths. Early diagnosis of primary prostate cancer, accurate staging, as well as accurate restaging in the case of cancer recurrence after primary treatment, are important for delivering the appropriate therapy. In the last ten years, functional and molecular imaging by means of PET and PET/CT are increasingly being used for such indications. This article provides a radiolabeled tracer-based review of the diagnostic value of PET and PET/CT in primary and recurrent prostate cancer. [¹⁸F]FDG, [¹¹C]acetate, [¹⁸F]fluoride, and [¹⁸F]- and [¹¹C]choline are reviewed in this frame with an emphasis on the radiolabeled choline derivates. PET/CT with radioactively labeled choline derivates is a promising molecular imaging technique for restaging prostate cancer patients with biochemical recurrence after definite primary therapy. However, for the diagnosis of primary prostate cancer, choline PET/CT cannot be recommended at the present time.