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Lipogenesis Pathway: Radiolabeled Choline

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Radiopharmaceuticals

Abstract

The radiolabeled choline is a PET/CT radiopharmaceutical useful in detecting tumors with high lipogenesis rate.

For this reason choline, labeled with 11C or 18F, is currently used as PET/CT tracer in the management of prostate cancer patients. Despite that its role is still unclear during the early stage of this disease, several studies support usefulness of radiolabeled choline PET/CT in evaluating patients with biochemical relapse of prostate cancer, following radiotherapy or radical prostatectomy for curative intent. In particular, the detection rate of radiolabeled choline of distant lymph node or bone metastases is strictly linked to PSA serum level at the time of the scan. Consequently, the diagnosis of tumor relapse in oligo-metastatic patients could help in choosing the best therapeutic approach in order to improve patient prognosis and quality of life.

Other tumors present malignant behavior but cannot be examined with 18F-FDG PET/CT, due to low grade of glucose metabolism expressed: under study is the potential role of radiolabeled choline PET/CT in the management of patients with bladder cancer and bronchioloalveolar and hepatocellular carcinoma.

The exact knowledge of the normal in vivo distribution of radiolabeled choline can help nuclear physicians in avoiding misdiagnosis, due to the abnormal tracer uptake in several benign or malignant conditions.

From the experience with these diagnostic pitfalls, several researchers proposed a feasible role of radiolabeled choline PET/CT in the management of patients with brain tumors or in the diagnosis of hyperparathyroidism.

Authors declare they have obtained permission for any previously published material used in their chapter.

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Abbreviations

18F-DOPA:

18F-Diidrossiphenil-alanine

18F-FDG:

18F-Fluorodeoxyglucose

18F-FECH:

18F-Ethylcholine

18F-FET:

18F-Fluoroethyltirosine

18F-FLT:

18F-Fluorothymidine

18F-FMC:

18F-Methylcholine

68Ga-PSMA:

68Ga-Prostate-specific membrane antigen

ADC:

Apparent diffusion coefficient

FDA:

Food and Drug Administration

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

PSA:

Prostate-specific antigen

SPECT:

Single photon emission tomography/computed tomography

SUVmax:

Maximum standardized uptake value

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Authors and Affiliations

  1. Department of Nuclear Medicine and Theranostics, “Mariano Santo” Hospital, Cosenza, Italy

    Ferdinando Calabria

  2. Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy

    Marzia Colandrea

  3. Nuclear Medicine Unit, Department of Diagnostic Imaging, Magna Graecia University, Catanzaro, Italy

    Giuseppe L. Cascini

  4. Department of Biomedicine and Prevention, University “Tor Vergata”, Rome, Italy

    Orazio Schillaci

  5. Department of Nuclear Medicine and Molecular Imaging, IRCCS Neuromed, Pozzilli, IS, Italy

    Orazio Schillaci

Authors
  1. Ferdinando Calabria
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  2. Marzia Colandrea
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  3. Giuseppe L. Cascini
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  4. Orazio Schillaci
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Correspondence to Ferdinando Calabria .

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Editors and Affiliations

  1. Department of Nuclear Medicine and Theranostics, Mariano Santo Hospital, Cosenza, Italy

    Ferdinando Calabria

  2. Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

    Orazio Schillaci

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Calabria, F., Colandrea, M., Cascini, G.L., Schillaci, O. (2020). Lipogenesis Pathway: Radiolabeled Choline. In: Calabria, F., Schillaci, O. (eds) Radiopharmaceuticals. Springer, Cham. https://doi.org/10.1007/978-3-030-27779-6_3

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