Evaluation of Sodium Fluoride PET in the Identification of Bone Metastases in Patients Having Undergone a Choline PET for Occult Recurrence of Prostatic Adenocarcinoma

Evaluation of Sodium Fluoride PET in the Identification of Bone Metastases in Patients Having Undergone a Choline PET for Occult Recurrence of Prostatic Adenocarcinoma

The purpose is to evaluate if sodium fluoride PET in patients having already undergone a choline PET negative for bone extension (non-metastatic status) modifies the status of patients concerning the existence or not of bone metastases.

Secondary purposes are:

• To evaluate if detection of bone metastasis by sodium fluoride PET, not detected by choline PET, leads to change of treatment
• To evaluate inter-technique concordance (choline vs sodium fluoride PET) of results (metastatic status and number of lesions)
• To evaluate the inter-judge concordance of interpretation of sodium fluoride PET
• To study the discordance of metastatic status of 2 techniques.

Inclusion Criteria:

• Prostate adenocarcinoma regardless of Gleason score
• Patients having undergone radical treatment (prostatectomy or radiotherapy (external or brachytherapy) +/- conco-adjuvant hormonal therapy)
• Level of Prostate Specific Antigen (PSA) indicating recurrence: PSA > 0.2 ng/ml in case of prostatectomy (in 2 consecutive tests in less than 1 month) or elevation of PSA of at least 2 ng/ml above nadir in case of radiotherapy or brachytherapy (in 2 consecutive tests in less than 1 month)
• Negative conventional assessment (thoracic-abdominal-pelvic scanner and bone scintigraphy) during 6 weeks before inclusion
• Patient having undergone a choline PET at CHRU Nancy
• Signed informed consent
• Affiliation to French social security
• Absence of contraindications to sodium fluoride PET

Exclusion Criteria:

• Refusal or impossibility of informed consent
• Patient incapable to consent
• Patient deprived of liberty
• Person under legal protection
• Person in life-and-death emergency
• Drug addiction, alcoholism, psychological problems affecting patient compliance
• Severe co-morbidities
• Modification of hormonal therapy (if applicable) during 3 months before inclusion
• Renal insufficiency (creatinine clearance < 60 ml/min) detected during last assessment before inclusion
• Other progressive tumors (recovered cancers are not a non-inclusion criteria)