Promising role of [18F] fluorocholine PET/CT vs [18F] fluorodeoxyglucose PET/CT in primary brain tumors—Early experience

• Published in: Clinical neurology and neurosurgery Vol. 113; no. 2; pp. 156 - 161
• Main Authors: Lam, Winnie Wing-Chuen, Ng, David Chee-Eng, Wong, Wai Yin, Ong, Seng Chuan, Yu, Sidney Wing-Kwong, See, Siew Ju
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-02-2011; Elsevier; Elsevier Limited
• Subjects: [18F] fluorocholine; [18F] fluorodeoxyglucose; Biological and medical sciences; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - pathology; Choline - analogs & derivatives; Fatal Outcome; Female; Fluorine Radioisotopes; Glioblastoma - diagnostic imaging; Glioblastoma - pathology; Glioma - diagnostic imaging; Glioma - pathology; Humans; Magnetic Resonance Imaging; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Neurology; Neurosurgery; Oligodendroglioma - diagnostic imaging; Oligodendroglioma - pathology; PET/CT; Positron-Emission Tomography; Primary brain tumors; Radiopharmaceuticals; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed; [18F] fluorodeoxyglucose; Primary brain tumors; [18F] fluorocholine; PET/CT; 2-deoxy-2-fluoroglucose; Nervous system diseases; Intracranial tumor; Cerebral disorder; Surgery; Central nervous system disease; Computerized axial tomography; Positron emission tomography; Fluorocholine (18F); Emission tomography
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2010.09.012

Abstract Primary brain tumors (PBT), in particular gliomas, are among the most difficult neoplasms to treat, necessitating good quality imaging to guide clinicians at many junctures. Current imaging modalities, including [18F] fluorodeoxyglucose (FDG) PET/CT, MRI and MR spectroscopy (MRS), have various limitations, particularly with regard to differentiating tumor from radiation induced necrosis (RIN) and from normal cerebral metabolic uptake. [18F] fluorocholine (FCH) is an analog of choline with potentially optimal imaging characteristics, as pharmacokinetic studies with FCH conducted in patients showed minimal FCH uptake by normal brain parenchyma, whereas high-grade tumors are known to have increased choline uptake. We present two cases of our early experience with FCH PET/CT for patients with PBT and discuss the potential use and comparative limitations of this imaging modality.