Choline PET/CT

Choline is a nutritional component that is incorporated by the body cells into their outer boundary (cell membrane). Various benign and malignant diseases lead to increased growth and metabolism of the cells, which leads to increased absorption of choline compared to healthy cells. This principle is used in the choline PET/CT examination. Radioactively labeled choline is administered to make the diseased tissue visible.

Indications/ Fields of Use

• Used to clarify a parathyroid adenoma in hyperparathyroidism (hyperactivity of the parathyroid gland) when no adenoma could be found in conventional diagnostics including parathyroid scintigraphy. An operation can be better planned and the extent of the operation can be reduced by a precise localization of the adenoma.
• Used to clarify unclear liver lesions (hepatocellular carcinoma, hepatoblastoma)
• Used for tumor localization in biochemical recurrence of prostate carcinoma. PSMA-PET/CT, the newer examination method of prostate cancer, is also available in our clinic. In consultation with your physicians an optimal plan of examination will be made.

Examination preparation

Fasting for 4 hours is recommended (although not absolutely essential). Since the radiopharmaceutical has a short half-life of less than 2 hours and is delivered especially for you, we ask for arrival on time at the agreed date. If you are unable to keep the appointment, please contact us as early as possible.

Documents

Please bring all relevant documents with you to the examination (especially imaging data and reports from previous examinations, preferably in digital form such as CD). In case of needed intravenous administration of contrast agents for CT (computed tomography), please have the creatinine level in the blood determined by your doctor as soon as possible - IDEALLY in the week before the examination.

Examination procedure

The tracer (radiopharmaceutical) 18F-Choline will be injected into an arm vein, which causes no side effects. After a waiting period of 45 minutes, in which the tracer is distributed in the body, the actual image acquisition (examination) is started on the PET/CT scanner.

The examination takes approx. 20 - 30 minutes and needs you to lie down in supine position. Depending on the indication, intravenous administration of iodine-containing contrast medium will be used.

The PET-CT scanner is open upwards (towards the head) and downwards (towards the legs) and less closed than a tube, thus not comparable to an MRI. In cases of pronounced claustrophobia, premedication may be necessary or advisable to relieve anxiety.

Please bear in mind that with such an anxiolytic medication you will not be able to drive on the day of the examination! If there is no "claustrophobia" (99% of cases), no such medication is required and you can drive yourself (before and after the examination).

Side effects

No side effects are to be expected from the injection of the radioactive tracer itself.

Side effects may arise from the administration of iodine-containing contrast material if a contrast-enhanced CT is added (intolerance reaction, hyperthyroidism, intensification of a pre-existing renal insufficiency). During your consultation with our physicians, please make sure to point out if you have experienced a contrast agent related reaction in the past (reddening of the skin, itching, swelling, shortness of breath, etc.).

Radiation exposure

The radiation exposure of choline PET/CT is approximately in the range of twice the natural annual radiation dose (approx. 4-8 mSv). It is below the radiation dose of most conventional CT examinations. Acute and/or chronic radiation damage from this examination is not to be expected or ever observed.