18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer

Abstract

Accurate knowledge of the biodistribution of 18F-choline is essential for the correct interpretation of PET/CT imaging. CT enables differentiation of physiological bowel activity and 18F-choline excretion in the ureters. In our series, 18F-choline uptake in benign pathological conditions mainly included sites of inflammation; nevertheless, accumulation in tumour deposits not because PC cannot be excluded, particularly in the brain, where correlative imaging with magnetic resonance is of the utmost importance.

18F-fluorocholine for prostate cancer imaging: a systematic review of the literature

“…47,[49][50][51][52][53][54] Two clinical studies evaluated the physiological distribution and false-positive 18 F-FCH uptakes. 55,56 The literature data on 18 F-FCH prostate cancer imaging are summarized in Table 1. 20,21 In humans, 18 F-FCH uptake was most pronounced in the kidneys and liver.…”

“…20,21,24,34,35,37,38,42,57 Early time points for imaging (0-15 min post-intravenous injection) and/or delayed imaging time points (30,40,45,60, 90-120 and 65-200 min post-intravenous injection) have been also described in the published literature. 22,23,[27][28][29][30][31][32][33]36,39,40,41,[43][44][45][46][47][48][49][50][51][52][54][55][56] 34 16…”

“…In addition to variations in scanning techniques, each study validated the 18 F-FCH scans by a variety of means: correlation with clinical outcomes, consensus gold standards based on clinical and standard imaging, or histopathological results. Particularly, the lack of biopsy confirmation within many of the patients studied needs to be considered; for example, Schillaci et al 56 noted a relatively high frequency (E19%) of false-positive results related to benign inflammatory lesions or other neoplasms.…”

Targeting Free Prostate-Specific Antigen forIn VivoImaging of Prostate Cancer Using a Monoclonal Antibody Specific for Unique Epitopes Accessible on Free Prostate-Specific Antigen Alone

“…[9][10][11][12][13] However, there is also uptake of both 18 F-and 11 C-labeled choline in benign disease conditions as well. 14 Prostate-specific antigen (PSA) is the gene product of KLK3, which is one of 15 kallikrein-related peptidase genes (KLK1-KLK15) on chromosome 19q13. 4.…”

A case of thymoma detected by 18F-choline positron emission tomography/computed tomography

“…Is known that proliferation of benign cellular types such as lymphocytes may be responsible for increased choline uptake in benign diseases such as phlogosis [3].…”