OVERVIEW

[^18F] Fluorocholine (F-Choline) is a radiopharmaceutical used in positron emission tomography (PET) imaging for various oncological applications, particularly in prostate cancer. It serves as a tracer for choline metabolism, which is elevated in proliferating cancer cells due to their increased membrane synthesis.

Mechanism of Action

F-Choline is an analog of choline, a precursor molecule for phospholipid synthesis and cell membrane formation. Cancer cells have higher demands for choline to support their rapid proliferation, resulting in increased uptake of choline analogs like F-Choline. Once administered, F-Choline is transported into cells via choline transporters and incorporated into phospholipids. The fluorine-18 radionuclide emits positrons that can be detected by PET scanners, allowing for the visualization and quantification of choline metabolism in tumors.

Applications in Oncology

F-Choline PET imaging has several clinical applications in oncology:

Prostate Cancer

  • Primary Tumor Detection: F-Choline PET is used to localize primary prostate tumors and assess their extent.
  • Staging: It helps detect local and distant metastases, including lymph node involvement and bone metastases.
  • Biochemical Recurrence: F-Choline PET is sensitive for detecting recurrent disease, particularly in patients with rising prostate-specific antigen (PSA) levels after primary treatment.

Other Cancers

  • Brain Tumors: F-Choline PET aids in distinguishing between tumor recurrence and post-treatment changes in patients with gliomas.
  • Breast Cancer: It may be useful in detecting primary breast tumors and assessing regional and distant metastases.

Advantages

F-Choline PET imaging offers several advantages over conventional imaging modalities: