fluorocholine and Inflammation

F-fluorocholine PET/CT is commonly used for staging and assessing treatment response in prostate cancer patients. Growing clinical experience has shown that F-fluorocholine can actually accumulate in sites of inflammation. We report a rare case of a prostate cancer patient with incidentally detected Peyronie disease.

Topics: Aged; Choline; Humans; Inflammation; Male; Middle Aged; Penile Induration; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms

(18)F-fluorocholine ((18)F-FCH) uptake is associated with cell proliferation and activity in tumor patients. We hypothesized that (18)F-FCH could similarly be a valuable imaging tool to identify vulnerable plaques and associated intraplaque inflammation and atheroma cell proliferation.. Ten consecutive stroke patients (90% men, median age 66.5 years, range, 59.4-69.7) with ipsilateral >70% carotid artery stenosis and who underwent carotid endarterectomy were included in the study. Before carotid endarterectomy, all patients underwent positron emission tomography to assess maximum (18)F-FCH uptake in ipsilateral symptomatic carotid plaques and contralateral asymptomatic carotid arteries, which was corrected for background activity, resulting in a maximum target-to-background ratio (TBRmax). Macrophage content was assessed in all carotid endarterectomy specimens as a percentage of CD68(+)-staining per whole plaque area (plaqueCD68(+)) and as a maximum CD68(+) percentage (maxCD68(+)) in the most inflamed section/plaque. Dynamic positron emission tomography imaging demonstrated that an interval of 10 minutes between (18)F-FCH injection and positron emission tomography acquisition is appropriate for carotid plaque imaging. TBRmax in ipsilateral symptomatic carotid plaques correlated significantly with plaqueCD68(+) (Spearman's ρ=0.648, P=0.043) and maxCD68(+) (ρ=0.721, P=0.019) in the 10 corresponding carotid endarterectomy specimens. TBRmax was significantly higher (P=0.047) in ipsilateral symptomatic carotid plaques (median: 2.0; interquartile range [Q1-Q3], 1.5-2.5) compared with the contralateral asymptomatic carotid arteries (median: 1.4; Q1-Q3, 1.3-1.6). TBRmax was not significantly correlated to carotid artery stenosis (ρ=0.506, P=0.135).. In vivo uptake of (18)F-FCH in human carotid atherosclerotic plaques correlated strongly with degree of macrophage infiltration and recent symptoms, thus (18)F-FCH positron emission tomography is a promising tool for the evaluation of vulnerable plaques.. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01899014.

Topics: Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Asymptomatic Diseases; Biomarkers; Carotid Arteries; Carotid Stenosis; Choline; Cross-Sectional Studies; Endarterectomy, Carotid; Female; Humans; Immunohistochemistry; Inflammation; Macrophages; Male; Middle Aged; Plaque, Atherosclerotic; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Prospective Studies; Radiopharmaceuticals; Rupture, Spontaneous; Severity of Illness Index