The Role of F-18 Choline PET and PET/CT in Prostate Cancer

Abstract

F-18 fluorocholine [fluoromethyl-dimethyl-2-hydroxyethyl-ammonium (FCH)] is a choline analogue that shows great structural similarity to natural choline. The pathophysiological basis for the use of choline and its derivates for prostate cancer (PC) imaging are the elevation of choline levels and the up-regulation of choline kinase activity in malignant cells. In order to allow rapid tumour growth, malignant cells are able to trap choline to produce phosphatidylcholine, part of the cellular membrane. As shown in recent studies, F-18 choline PET and PET/CT might be a valuable tool in detecting the primary tumour in case of elevated prostate-specific antigen (PSA) serum levels. However, data are not consistent, and further research is necessary before general recommendations concerning F-18 choline PET and PET/CT can be given in this setting. Furthermore, some studies investigated the accuracy of F-18 choline PET and PET/CT in detecting lymph node or bone metastases and local recurrences in case of PSA relapse in patients with a history of PC.