C-11 Choline PET Scan

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WHAT IS C-11 CHOLINE PET SCAN? C-11 Choline PET scan is an imaging test used in detecting sites of prostate cancer that has recurred, despite treatment. It may be used when other imaging has failed. This positron emission tomography (PET) scan uses a special chemical tracer called C-11 Choline Injection. This imaging test is done… Read More

C-11 Choline PET Scan

WHAT IS C-11 CHOLINE PET SCAN?

C-11 Choline PET scan is an imaging test used in detecting sites of prostate cancer that has recurred, despite treatment. It may be used when other imaging has failed.

This positron emission tomography (PET) scan uses a special chemical tracer called C-11 Choline Injection. This imaging test is done alongside a low-dose computerized tomography (CT) scan to help further show internal anatomy.

USES OF C-11 CHOLINE PET SCAN

C-11 Choline PET scan can help doctors:

  • Detect possible sites of recurrent prostate cancer that ordinary imaging tests cannot identify.
  • Detect early location of the recurrent prostate cancer, which enables identification of small, isolated deposits of cancer, within and outside the prostate; for a more effective treatment.

SYMPTOMS OF PROSTATE CANCER

Some people have no early symptoms until cancer develops over years, while others show early indications. These signs may include:

  • Frequent urination.
  • Difficulty in starting or stopping urination.
  • Blood in urine or semen (which is quite rare).
  • Weak, interrupted, and slow urine stream.
  • Applying pressure while urinating.
  • Urinary stream splits.
  • Discomfort, due to pain or burning sensation, with urination or ejaculation.
  • Intense pain in the lower back, hips, or thighs.
  • Longer time to urinate.
  • Inability to empty the prostate.
  • Sudden urging and pressing urination.

COMPLICATIONS OF PROSTATE CANCER

Any detailed treatment of prostate cancer may result in:

  • Metastasizes

Prostate cancer can spread outside the prostate, to nearby organs (such as the bladder); or through your bloodstream (or perhaps the lymphatic system), to the bones or other organs.

  • Impotency or Erectile Dysfunction

Genital weakness makes you unable to keep an erection. Impotency can cause stress or strained relationships.

  • Incontinence

You may be unable to voluntarily control urination. This may lead to public embarrassment and a lack of self-esteem. Incontinence is a societal nuisance.

  • Life-Threatening

Prostate cancer may lead to severe consequences, such as loss of life.

RISK FACTORS OF PROSTATE CANCER

Certain factors make some people prone to have prostate cancer. They include:

  • Age, as the risks increase with age (especially after age 50).
  • Race (more likely to affect blacks more than other races).
  • Family History

Prostate cancer tends to run in families, called familial prostate cancer. Secondly, in families where people suffer from breast cancer or ovarian cancer, men are likely to have prostate cancer.

  • Genetic Changes

Genes that carry an increased risk of developing prostate cancer include:

  • BRCA1.
  • BRCA2.
  • HBOC.
  • HPC1.
  • HPC2.
  • HPCX.
  • CAP3.
  • ATM.
  • FANCA.
  • HOXB13.

 

  • Exposure to Agent Orange

Agent Orange is a chemical that was used during the Vietnam War. A veteran of the war is likely to be at risk of having prostate cancer.

  • Eating Habits

Obesity is associated with prostate cancer. Try healthy diets to repel weight gain.

  • Inactivity Lifestyle

Prostate cancer increases among those with low physical activity. This is common in a city, where individuals sacrifice physical activities in search of wealth.

RISKS OF C-11 CHOLINE PET SCAN

Possible risks which may go with the C-11 Choline PET scan for prostate cancer include:

  • Imaging Errors

To reduce imaging errors, the C-11 Choline PET test is done at the same time with a low-dose CT scan to help further show internal anatomy.

  • Allergic Reaction to Choline C-11

Some people can be allergic to C-11 Choline chemicals.

  • Exposure to Radiation

C-11 Choline Injection contributes to a patient’s accumulative radiation exposure.

  • Mild injection site reactions.

PREPARATION FOR THE C-11 CHOLINE PET SCAN

In preparing for the C-11 Choline PET scan, do the below, except your doctor instructs you on not doing them:

  • Don’t eat or drink anything, except for water, for 6 hours before the scan.
  • Your last meal before the test should include high protein foods and plenty of water.
  • Avoid carbohydrate foods and foods with sugar.
  • You can continue with your prescribed medications.

WHAT IS CHOLINE?

Choline is an essential nutrient for humans, as well as other animals. It occurs as a cation that forms various salts. With the formula C₅H₁₄NO, molar mass 104.1708gram per mole (g/mol), and boiling point 305°C, choline are soluble both in water and alcohol.

To maintain health, choline must be obtained from the diet as choline or as choline phospholipids, such as phosphatidylcholine.

Chemically, choline has played a major role in detecting possible sites of recurrent prostate cancer.

PROCEDURE FOR C-11 CHOLINE PET SCAN

This imaging test uses a radioactive form of vitamin choline for tracer injection. The procedure takes 20 minutes.

  1. You will be asked to lie on your back on a moving table and moved to the scanners.
  2. A small amount of the tracer is injected into your vein in your arm just before the scan is done.
  3. Your body’s prostate cancer cells readily absorb the tracer. This can help the doctor through the C-11 choline PET scan locations of prostate cancer cells anywhere in your body.
  4. A biopsy to remove some cells from your body (preferably prostrate) for lab testing is then done to confirm the presence of recurrent prostate cancer.

RESULTS OF C-11 CHOLINE PET SCAN

After the test, a urologist will analyze your result. Generally, all tracers leave your body after 2 days. Meanwhile, a specialist will interpret the PET scan images and share the information with your doctor.

The result is normally ready for your doctor within 2 days (holidays exclusive) and your doctor studies the result, then goes over the result with you at your follow-up meeting.

Positive results are graded in percentage calcification and show the C-11 choline PET/CT positivity.

PROGNOSIS

Early detection of recurrent prostate cancer may save a lot of complications. Through a C-11 choline PET scan, prostate cancer can be detected by doctors and they can also recurrence of prostate cancer cells before it may be detected by the ordinary imaging test.

In patients with heightening prostate-specific antigens (PSA) levels, the test may help detect sites of possible recurrent prostate cancer at PSA levels as low as 2ng/mL. A C-11 choline PET scan also helps doctors differentiate between scar tissue, inactive cancer cells, and active recurrent prostate cancer.

FAQs

  • What is the role of a choline PET scan?

Choline is an imaging test used in detecting sites of prostate cancer that has recurred despite treatment, even if other imaging tests have failed. It enables the identification of small, isolated deposits of cancer, within and outside of the prostate for effective treatment. It helps doctors distinguish between scar tissues, inactive cancer cells, and active recurrent prostate cancer.

  • What happens if I do not treat my prostate cancer?

Sometimes, prostate cancer may look mild but it can lead to serious complications if left untreated. Complications of untreated prostate cancer may include:

  • Spreading to other nearby organs, such as the bladder, bones, and other organs of the body.
  • You may have erectile dysfunction (impotency)
  • Inability to control urination (incontinence)
  • Prostate cancer can be life-threatening as it can hinder the functioning of other organs.

Therefore, it is necessary to treat it as soon as you notice the symptoms.

  • Can my lifestyle cause prostate cancer?

Yes. Obesity which is associated with prostate cancer can cause uncontrolled eating habits. Prostate cancer appears to increase among people with low physical activities. Exercise reduces the chances of prostate cancer. Other risk factors of prostate cancer include old age, race, and family history.

  • Can C-11 choline PET scan affect my medications?

In preparing for the C-11 choline PET scan, except your doctor instructs otherwise do not to eat or drink anything except water for 6 hours before the scan, you can continue with your prescribed medication, avoid carbohydrate and foods with sugar, and your last food before the test should include high protein foods and plenty of water.

  • Is injecting choline into the body not harmful?

Choline is an essential nutrient for humans. To maintain health, choline should be in our diet in the form of phospholipids. 

However, a C-11 choline PET scan may be associated with minor risks. Possible risks may include:

  • Imaging errors
  • Allergic reactions to C-11 choline injection
  • Exposure to radiations
  • Mild injection site reactions.