title: 18F-fluorocholine for prostate cancer imaging: a systematic review of the literature.
abstract: BACKGROUND
  Positron emission tomography (PET or combined PET-computed tomography (PET/CT)) allows the non-invasive interrogation of metabolic processes using radiolabeled probes. Altered choline metabolism has been noted as a characteristic of prostate cancer (PCa), and radiolabeled choline and choline analogs have been investigated as PET/CT imaging agents for prostate cancer; [(18)F]fluoromethyl-dimethyl-2-hydroxyethyl-ammonium ((18)F-FCH) shows particular promise as a PCa imaging agent given its favorable physical and pharmacokinetic properties.
  
  
  METHODS
  We conducted a systematic review of results to date with (18)F-FCH. As the tracer was first described by DeGrado in 2001, we limited our search from January 2001 to August 2011.
  
  
  RESULTS
  In all, 37 studies including 1244 patients met the inclusion criteria. Studies included those detailing the radiosynthesis of (18)F-FCH, preclinical and early clinical dosimetry, and biodistribution (n=7); evaluation of local disease (n=6), nodal disease (n=5), bone metastases and castrate-resistant disease (n=7), biochemical recurrence (n=11), radiotherapy planning (n=7) and sources of false-positive studies (n=2); and some studies reported on multiple indications. Potential sources of variations in the studies affecting reported performance included case series size, variation in extent of disease at imaging (including Gleason grade, and PSA), selection of gold standards for comparison and variations in scan technique.
  
  
  CONCLUSIONS
  On the basis of the review, we suggest potential scenarios where this metabolic imaging might be considered for further evaluation in clinical trials for guiding PCa management.
authors.affiliation: Department of Oncology, The University of Western Ontario, London Health Sciences Centre-St Joseph's Healthcare Centre, London, Ontario, Canada. Glenn.bauman@lhsc.on.ca
authors.forename: G
authors.initials: G
authors.lastname: Bauman
authors.forename: T
authors.initials: T
authors.lastname: Belhocine
authors.forename: M
authors.initials: M
authors.lastname: Kovacs
authors.forename: A
authors.initials: A
authors.lastname: Ward
authors.forename: M
authors.initials: M
authors.lastname: Beheshti
authors.forename: I
authors.initials: I
authors.lastname: Rachinsky
mesh_terms: D002794:Choline / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009919:Orchiectomy; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D011829:Radiation Dosage; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; C514960:fluorocholine; D002794:Choline