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Morphological aspects in recurrent prostate cancer

On molecular imaging for local salvage treatment
PhD ceremony:Mr M. (Maxim) Rybalov
When:March 04, 2015
Start:14:30
Supervisors:prof. dr. I.J. de Jong, prof. dr. R.A.J.O. (Rudi) Dierckx, Prof. S. Al-Shukri
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Morphological aspects in recurrent prostate cancer

Detection and staging of recurrent prostate cancer after surgery or radiation treatment is still one an important clinical problem. At present there is no conventional imaging technique that can determine the exact localization of recurrent tumors, mostly for their small size. With a growing interest and possibilities of focal treatment of recurrent prostate cancer by ablative treatments like high intensity focused ultrasound and cryoablation, patient selection could be improved if the site of recurrence and its extent could be visualized. The aim of this thesis was to study the clinical value of 11C-choline PET/CT in recurrent prostate cancer and explore its potential for image guided cryoablation. The results of the clinical studies showed that 11C-choline PET/CT has a high overall sensitivity in detection of a local recurrence in the prostate after external beam radiotherapy (EBRT) on a patient based analysis. Therefore, it can be useful for the selection of patients with a biochemical recurrence after radiotherapy for whole organ salvage cryoablation of the prostate. At the same time the results of the clinical studies showed that 11C-choline PET/CT has a low accuracy in the characterisation of a local recurrence in the prostate after EBRT on a lesion based analysis. This limits the use of 11C-choline PET/CT as routine imaging technique for image guided focal treatment, probably by the non-cancer specific nature of the choline tracer. We identified cancer specific targets in recurrent prostate cancer, which could improve the clinical value of PET/CT or PET/MRI in the near future.