Biochemical and Pathophysiological Premises to Positron Emission Tomography with Choline Radiotracers

Choline is a quaternary ammonium base that represents an essential component of phospholipids and cell membranes. Malignant transformation is associated with an abnormal choline metabolism at a higher levels with respect to those exclusively due to cell multiplication. The use of Positron Emission Tomography/Computed Tomography (PET/CT) with radiocholine (RCH), labeled with (11) C or (18) F, is widely diffuse in oncology, with main reference to restaging of patients with prostate cancer. The enhanced concentration in neoplasm is based not only on the increasing growing rate, but also on more specific issues, such as the augmented uptake in malignant cells due to the up-regulation of choline kinase. Furthermore the role of hypoxia in decreasing choline's uptake determine an in vivo concentration only in well oxygenated tumors, with a lower uptake when malignancy increases, i.e. in tumors positive at (18) F-Fluoro-deoxyglucose. In this paper we have analyzed the most important issues related to the possible utilization of RCH in diagnostic imaging of human cancer. This article is protected by copyright. All rights reserved.

Journal of cellular physiology. 2016 Jul 06 [Epub ahead of print]

Vincenzo Cuccurullo, Giuseppe Danilo Di Stasio, Laura Evangelista, Gabriella Castoria, Luigi Mansi

Nuclear Medicine Unit, Department of Clinical and Experimental Internistic "F.Magrassi, A.Lanzara" - Seconda Università di Napoli, Napoli, Italy., Nuclear Medicine Unit, Department of Clinical and Experimental Internistic "F.Magrassi, A.Lanzara" - Seconda Università di Napoli, Napoli, Italy., Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto (IOV-IRCCS), Padova, Italy., Department of Biochemistry, Biophysics and General Pathology, Seconda Università di Napoli, Napoli, Italy., Nuclear Medicine Unit, Department of Clinical and Experimental Internistic "F.Magrassi, A.Lanzara" - Seconda Università di Napoli, Napoli, Italy.