The role of PET/computed tomography scan in the management of prostate cancer

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Abstract
To evaluate the role of PET/computed tomography (CT) imaging in patients with prostate cancer and to provide clinical recommendations, both in pretreatment and in post-treatment phase. The potential role of PET/CT for evaluating intraprostatic disease, staging and restaging prostate cancer patients has been largely investigated. In particular, among the different PET tracers evaluated, choline, acetate and fluoride are showing the most promising results for imaging prostate cancer and its metastases. However, although choline PET/CT is an established diagnostic tool for imaging prostate cancer patients, as documented by a large amount of literature, further studies are still necessary to establish the final clinical role of PET/CT with acetate and fluoride. Choline PET/CT is clinically indicated to noninvasively restage, in one single session, prostate cancer patients presenting a progressive increase of prostate-specific antigen, after radical treatment. Conversely, choline PET/CT does not allow the accurate assessment of intraprostatic tumor and of small lymph nodal involvement, thus not being currently recommended as a first-line method for initial diagnosis and staging. The current use of PET/CT with acetate and fluoride in clinical practice still needs further confirmations.

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