Ferdinando Calabria1, Agostino Chiaravalloti, Orazio Schillaci. 1. From the *Department of Nuclear Medicine and Molecular Imaging, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico Mediterraneo Neuromed, Pozzilli; and †Department of Biomedicine and Prevention, University "Tor Vergata," PTV Foundation-Policlinic "Tor Vergata," Rome, Italy.
Abstract
OBJECTIVES: F-choline PET/CT is an important diagnostic tool in the management of patients with prostate cancer (PC). The aim of this study was to describe and discuss some abnormal sites of uptake that we observed, not due to PC recurrence. PATIENTS AND METHODS: Three hundred patients were submitted to F-choline PET/CT for staging or restaging of PC. Whole-body PET/CT was acquired 40 minutes after the F-choline administration. RESULTS: We found abnormal uptake of the tracer, not related to PC, in 48/300 patients (16%). Most of these findings were due to inflammatory processes. Furthermore, some malignant conditions, such as a case of colon cancer, a case of bladder carcinoma, and a multiple myeloma, were diagnosed. Mild uptake was also detected in some benign diseases, such as thymoma, adrenal adenoma, and sarcoidosis. Six patients showed focal brain uptake in correspondence to a meningioma. CONCLUSIONS: It is necessary for nuclear physicians, during clinical practice, to consider the possibility of F-choline uptake in some benign or malignant conditions for the intrinsic pharmacologic property of the tracer. An accurate medical investigation, correlative imaging with CT and/or MRI with contrast agents, laboratory data, and above all, histologic examination are often necessary for correct diagnosis.
OBJECTIVES:F-choline PET/CT is an important diagnostic tool in the management of patients with prostate cancer (PC). The aim of this study was to describe and discuss some abnormal sites of uptake that we observed, not due to PC recurrence. PATIENTS AND METHODS: Three hundred patients were submitted to F-choline PET/CT for staging or restaging of PC. Whole-body PET/CT was acquired 40 minutes after the F-choline administration. RESULTS: We found abnormal uptake of the tracer, not related to PC, in 48/300 patients (16%). Most of these findings were due to inflammatory processes. Furthermore, some malignant conditions, such as a case of colon cancer, a case of bladder carcinoma, and a multiple myeloma, were diagnosed. Mild uptake was also detected in some benign diseases, such as thymoma, adrenal adenoma, and sarcoidosis. Six patients showed focal brain uptake in correspondence to a meningioma. CONCLUSIONS: It is necessary for nuclear physicians, during clinical practice, to consider the possibility of F-choline uptake in some benign or malignant conditions for the intrinsic pharmacologic property of the tracer. An accurate medical investigation, correlative imaging with CT and/or MRI with contrast agents, laboratory data, and above all, histologic examination are often necessary for correct diagnosis.