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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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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