• Semi-quantitative analysis of tracer uptake using standard uptake values and qualitative analysis using pure visual analysis [ Designated as safety issue: No ]
• Development of an algorithm that includes the routine use of C-11 choline PET-CT scan for the staging of prostate cancer [ Designated as safety issue: No ]
• Correlation of C-11 choline PET-CT scan positivity with biochemical relapse-free survival, time to development of clinically apparent metastases, time to local failure, and overall survival [ Designated as safety issue: No ]

RATIONALE: New diagnostic procedures, such as C-11 choline PET-CT scan, may be effective in finding cancer that has spread to the bone and lymph nodes in patients with prostate cancer.

PURPOSE: This clinical trial is studying how well C-11 choline PET-CT scan works in finding metastases in patients with newly diagnosed high-risk prostate cancer.

OBJECTIVES:

Primary

• To determine the sensitivity and specificity of PET-CT scan using C-11 choline in detecting bone and lymph node metastases in patients with newly diagnosed high-risk adenocarcinoma of the prostate.

Secondary

• To perform semi-quantitative analysis of tracer uptake using standard uptake values and qualitative analysis using pure visual analysis.
• To develop an algorithm that includes the routine use of C-11 choline PET-CT scan for the staging of patients with prostate cancer at high risk of metastatic disease.
• To determine whether the presence of C-11 choline PET-CT scan positivity in these patients is predictive of outcomes, including biochemical relapse-free survival, time to development of clinically apparent metastases, time to local failure, and overall survival.
• To obtain tissue specimens from these patients for correlative studies and further evaluation.
• To obtain information regarding the feasibility and characteristics of C-11 choline PET-CT scan after androgen suppression.

OUTLINE: Patients undergo CT scan of the abdomen and pelvis with IV contrast and a bone scan. Patients also undergo a C-11 choline PET-CT scan*. In the case of any positive scan, patients undergo a needle biopsy. If the biopsy is negative for metastatic disease or if the biopsy is positive for metastatic disease in a draining lymph node region, patients receive radiotherapy and hormonal (antiandrogen) therapy. If the biopsy is positive for metastatic disease at any other site, patients receive hormonal therapy alone.

NOTE: *The first 10 patients enrolled on the study who have a positive PET-CT scan and positive biopsy undergo a second PET-CT scan at 6 months after the initial PET-CT scan.

Patients are followed every 3 months for 1 year and then every 6 months for 1 year.

• Dietary Supplement: C-11 choline
• Procedure: bone scan
• Procedure: computed tomography
• Procedure: needle biopsy

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the prostate

  • Prior negative prostate biopsy allowed

• High-risk disease, as defined by one of the following:

  • PSA ≥ 20 ng/mL
  • Gleason score ≥ 8
  • Digital rectal examination revealing ≥ T2c disease (tumor involving more than one half of one lobe of the prostate)

PATIENT CHARACTERISTICS:

• Creatinine < 2.0 mg/dL
• Able to tolerate PET scan, CT scan, and bone scan
• Able to tolerate IV and oral contrast
• Willing to undergo biopsy of positive findings on PET-CT scan, CT scan, or bone scan
• No other cancer within the past 5 years except for nonmelanoma skin cancer

PRIOR CONCURRENT THERAPY:

• No prior radiotherapy, hormonal therapy, surgery (other than biopsy), or cryotherapy for prostate cancer
• Prior transurethral resection of the prostate allowed