Choline PET/CT for imaging prostate cancer: an update

Whole-body positron emission tomography/computed tomography (PET/CT) with ¹¹C]- and ¹⁸F]-labeled choline derivates has emerged as a promising molecular imaging modality for the evaluation of prostate cancer. ¹¹C- and ¹⁸F-choline PET/CT are used successfully for restaging prostate cancer in patients with biochemical recurrence of disease after definitive therapy, especially when the serum prostate-specific antigen level is >1.0 ng/mL. ¹¹C- and ¹⁸F-choline PET/CT have more limited roles for the initial staging of prostate cancer and for the detection of tiny lymph node metastases due to the low spatial resolution inherent to PET. Overall, these modalities are most useful in patients with a high pre-test suspicion of metastatic disease. The following is a review of the current clinical roles of ¹¹C- and ¹⁸F-choline PET/CT in the management of prostate cancer.