[F-18]-Fluorocholine Injection (“[F-18]-FCH”), when used with positron emission tomography (PET), is being developed as a non-invasive imaging biomarker for the in vivo assessment of cellular proliferation and/or choline kinase upregulation. Clinical studies with a variety of cancer types suggest that [F-18]-FCH has potential as a tool for diagnosis, treatment planning, and tumour grading in cancers such as prostate cancer and hepatocellular carcinoma.
The uptake and metabolism of [F-18]-FCH closely mimics that of choline. Choline enters the cell using choline-specific transporters and is then predominately metabolised to phosphatidyl choline which is incorporated into the cell membrane. Since rapid cellular proliferation is a hallmark of cancer, there is an increased requirement for choline, reflected by upregulation of the choline metabolic pathway and/or choline transport; this results in increased choline uptake which is the basis for [F-18]-FCH PET imaging.
Cimitan M, Evangelista L, Hodolic M et al. Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients. J Nucl Med. 2015; 56(2): 209-15.
Evangelista L, Zattoni F, Guttilla A et al. Choline PET or PET/CT and biochemical relapse of prostate cancer: a systematic review and meta-analysis. Clin Nucl Med. 2013; 38(5): 305-314.
Umbehr MH, Muntener M, Hany T et al. The role of 11C-choline and 18F-fluorocholine positron emission tomography (PET) and PET/CT in prostate cancer: a systematic review and meta-analysis. Eur Urol. 2013; 64(1): 106-117
Bauman G, Belhocine T, Kovacs M et al. 18F-fluorocholine for prostate cancer imaging: a systematic review of the literature. Prostate Cancer and Prostatic Diseases. 2012; 15:45-55.
These references are provided for informational purposes only and do not represent an endorsement for any particular clinical use.
The safety and efficacy of [F-18]-FCH Injection have not been fully established and it has not been approved by Health Canada as a commercial product for medicinal use. It is an investigational drug product and can only be used under an approved clinical trial application (CTA). Please contact the CPDC if you require further information.