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Molecular imaging of brain tumors with radiolabeled choline PET

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Abstract

Several positron emission tomography (PET) radiopharmaceuticals have been emerged in the last decade as feasible in the management of brain lesions, due to the low performance in this field of the 18F-fluoro-deoxyglucose (18F-FDG), for its high physiological gradient of distribution in the brain. Beyond its usefulness in prostate cancer imaging, the radiolabeled choline is becoming a promising tool in diagnosing benign and malignant lesions of the brain, due to a very low rate of distribution in normal white and grey matters. The aim of our review was to assess the real impact of the radiolabeled choline PET/CT in the management of brain benign lesions, brain tumors, and metastases. Furthermore, emphasis was given to the comparison between the radiolabeled choline and the other radiopharmaceuticals in this field. A literature review was performed. The radiolabeled choline is useful in the management of patients with suspected brain tumor relapse, especially in association with magnetic resonance imaging (MRI), with caution regarding its intrinsic characteristic of non-tumor-specific tracer. For the same reason, it is not useful in the early evaluation of brain lesions. Similar results are reported for other radiopharmaceuticals. The inclusion of the head in the whole-body scans for somatic tumors is necessary to ensure metastases in the brain or choline-avid benign lesions.

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Acknowledgments

The authors wish to thank the radiologist technician Federico Rocca for the assistance in editing the manuscript.

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Authors and Affiliations

  1. Neuroimaging PET/MRI Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, IBFM CNR, Catanzaro, Italy

    Ferdinando Franco Calabria

  2. Department of Neurosurgery, II University of Naples, Naples, Italy

    Manlio Barbarisi

  3. Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy

    Vincenzo Gangemi

  4. Department of Neuroradiology, IRCCS Neuromed, Pozzilli, IS, Italy

    Giovanni Grillea

  5. Department of Diagnostic Imaging, Nuclear Medicine Unit, Magna Graecia University, Catanzaro, Italy

    Giuseppe Lucio Cascini

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  1. Ferdinando Franco Calabria
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  5. Giuseppe Lucio Cascini
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Correspondence to Ferdinando Franco Calabria.

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Calabria, F.F., Barbarisi, M., Gangemi, V. et al. Molecular imaging of brain tumors with radiolabeled choline PET. Neurosurg Rev 41, 67–76 (2018). https://doi.org/10.1007/s10143-016-0756-1

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