PSMA and C-11 Choline PET in Patients With Biochemical Recurrence of Prostate Cancer

Inclusion criteria

• Histopathological proven prostate adenocarcinoma.
• Rising PSA after definitive therapy with prostatectomy or radiation therapy (external beam or brachytherapy).

a. Post radical prostatectomy (RP) - with or without radiation. i. PSA greater than or equal to 0.2 ng/mL measured more than 12 weeks after RP. ii. > 3 months post-surgery b. Post-radiation therapy ASTRO-Phoenix consensus definition c. May or may not be castrate resistant (list prior therapies)

• Karnofsky performance status of 50 (or ECOG/WHO equivalent).
• CT or as part of the PET study or performed within one month of PSMA PET.
• Age > 18.
• Ability to understand a written informed consent document, and the willingness to sign it.

Exclusion criteria

• Undergoing investigational therapy for prostate cancer.
• Other ongoing treatments for prostate cancer including radiation therapy, chemotherapy or androgen deprivation. Androgen deprivation within the last 4 months excluding finasteride, dutasteride or other 5 alpha reductase inhibitors (excluding castrate resistant subjects).
• Unable to lie flat, still or tolerate a PET scan.
• Prior history of any other malignancy within the last 2 years, other than skin basal cell or cutaneous superficial squamous cell carcinoma that has not metastasized and superficial bladder cancer.
• Contraindication to furosemide administration including prior allergy or adverse reaction to furosemide or sulfa drugs. (Note: This exclusion criteria can be removed if Furosemide is omitted as part of the PET imaging protocol if a second-generation scatter correction is available for the used PET device).
• Absence of PSA and total testosterone tests within 4 weeks.