75 year old gentleman with a history of prostate ca and rising PSA levels.
FCH (F18 choline) uptake is seen in the periphery of a partially calcified mass at the anterior aspect of the left frontal lobe with adjacent edema.
F18 choline avid incidentiloma
Glioblastoma and meningioma.
Meningioma. FCH uptake is seen in the periphery of a partially calcified mass at the anterior aspect of the left frontal lobe with adjacent edema. This corresponds to the known meningioma at the site as described on the previous CT scan 6 months ago.
F18 choline PET/CT is acquired for imaging prostate cancer and its role is evolving.
Scan sensitivity has been reported as 77% in patients with a PSA level of greater than 0.3 ng/mL.
The sensitivity of the (18)F-FCH PET was significantly higher (85%) in patients with ongoing androgen deprivation therapy (ADT) than in patients without ADT (59.5%).
Patient management was reported as changed in 49.6 % of those with a positive FCH PET/CT scan and in 20 % of those with a negative FCH PET/CT scan.
FCH head and neck incidentilomas have been reported in 1.9% of cases.
80% of incidentilomas have been reported as Benign: pituitary adenomas, meningiomas, hyperfunctioning parathyroid glands and thyroid adenoma.
Malignant: Prostate cancer metastasis, papillary thyroid cancer metastasis.
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Eur J Nucl Med Mol Imaging. 2015 Nov;42(12):1784-93. Prognostic value of metabolic parameters and clinical impact of ¹⁸F-fluorocholine PET/CT in biochemical recurrent prostate cancer. Colombié M et al.
J Nucl Med. 2013 Jun;54(6):833-40. Impact of 18F-choline PET/CT in prostate cancer patients with biochemical recurrence: influence of androgen deprivation therapy and correlation with PSA kinetics. Beheshti M et al.