Response Assessment of 223Ra Treatment: Should a Fluorocholine PET/CT Be Performed?

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We present 3 cases of patients with castration-resistant prostate cancer and bone metastases treated with 223Ra, belonging to our prospective and multicenter ChoPET-Rad study. All patients underwent clinical, hematological, and biochemical monitoring between each 223Ra administration. Initial and follow-up 18F-fluorocholine PET/CT and 99mTc-biphosphonate bone scintigraphy were performed previously and after the third 223Ra administration. Both techniques correctly established the response to treatment, in agreement to the biochemical response, although differences in the disease expression (concordant and discordant patterns) were found because of the different radiotracer biodistribution and molecular information derived from them.

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