title: Impact of fasting on (18)F-fluorocholine gastrointestinal uptake and detection of lymph node metastases in patients with prostate cancer.
abstract: BACKGROUND
  (18)F-fluorocholine PET/CT is used to detect lymph node metastases in prostate cancer patients. Physiological (18)F-fluorocholine in the gastrointestinal tract, especially in the intestines, may interfere with the detection of malignant lymph nodes. Fasting is frequently proposed in literature; however, scientific support is lacking. This study aims to determine the impact of fasting on (18)F-fluorocholine uptake in the gastrointestinal tract.
  
  
  METHODS
  Eighty patients were studied, 40 fasted for at least 6 h prior to (18)F-fluorocholine administration while the other 40 did not fast. (18)F-fluorocholine uptake pattern and intensity were evaluated in the intestine near the abdominal aorta and four regions near the iliac arteries. (18)F-fluorocholine intensity was also measured in the liver, pancreas, stomach and spleen.
  
  
  RESULTS
  No statistically significant differences were found in (18)F-fluorocholine uptake in the gastrointestinal tract between the fasting and non-fasting group.
  
  
  CONCLUSIONS
  Fasting for 6 h has no effect on (18)F-fluorocholine uptake in the gastrointestinal tract. Therefore, no effects on the detection of malignant lymph nodes are expected, and fasting is not recommended in our opinion.
authors.affiliation: Department of Nuclear Medicine, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands. M.Wondergem@mca.nl.|Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. M.Wondergem@mca.nl.
authors.forename: Maurits
authors.initials: M
authors.lastname: Wondergem
authors.affiliation: Department of Nuclear Medicine, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
authors.forename: Friso M
authors.initials: FM
authors.lastname: van der Zant
authors.affiliation: Department of Nuclear Medicine, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
authors.forename: Remco J J
authors.initials: RJ
authors.lastname: Knol
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Department of Nuclear Medicine, Tygerberg Hospital, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Jan
authors.initials: J
authors.lastname: Pruim
authors.affiliation: Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Igle J
authors.initials: IJ
authors.lastname: de Jong
keywords: 18F-fluorocholine; PET/CT; Patient preparations; Prostate cancer; Urology