We revisited our early multiparametric dynamic choline PET data to demonstrate methodological feasibility for kinetic modelling and to highlight lessons relevant for current prostate-specific membrane antigen (PSMA) PET protocols.
Nine men (aged 48-81 years) with biochemical recurrence of prostate cancer (prostate-specific antigen [PSA] range: 0.12-45.1 μg/L) underwent dynamic 18F-FECH PET/computed tomography. Patlak analysis produced two outcome values, influx rate (Ki) and volume of distribution. For quantitative analysis region of interests (ROIs) were drawn on a metabolically active focus of the prostate. For semiquantitative analysis the tracer accumulation in the ROIs was measured using the standardised uptake value. Arterial input functions were derived visually, and Patlak graphical analysis was performed. Correlations were explored between kinetic parameters, Gleason grade, and serum PSA. Spearman's correlation coefficients were calculated to assess the possible association between 18F choline uptake, clinical and histopathological characteristics.
Dynamic acquisitions were technically feasible and analyzable before urinary excretion obscured the prostate. Time-activity curves plateaued after 1-2 min, and Patlak plots showed bilinear behaviour with measurable Ki and volume of distribution. Cancerous prostate tissue demonstrated increased perfusion compared with background tissue. No significant correlation was observed between kinetic parameters and PSA or Gleason grade.
Dynamic 18F-choline PET provided quantitative kinetic parameters reflective of tumour perfusion. Although choline imaging has been largely superseded by PSMA PET because of superior tumour-to-background contrast and specificity, the technical principles established in this study remain directly applicable to current PSMA kinetic and parametric imaging.
Nuclear medicine communications. 2026 May 19 [Epub ahead of print]
Athar Haroon, Ahmad Almuhaideb, Sola Adeleke, Raymond Endozo, Kjell Erlandsson, Ghulam Mustafa Shah Syed, Mark Emberton, Jamshed Bomanji
Nuclear Medicine Department, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK., Radiology Department, Nuclear Medicine Section, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., NIHR Academic Clinical Fellow in Clinical Oncology, King's College London., Institute of Nuclear Medicine, University College London Hospital, London, UK., Molecular Imaging and Nuclear Medicine, Hamad Medical Corporation, Doha, Qatar., Division of Surgery and Interventional Science, University College London, London, UK.