PET total body with Choline

What is it?

Positron Emission Tomography (PET) is a diagnostic imaging examination based on the intravenous administration of a small amount of radioactive tracer (radiopharmaceutical) characterized by the emission of particles called positrons. The radiopharmaceutical consists of a radioactive component and a molecule that tracks the metabolic process of interest. For the study in prostatic neoplasia the radiopharmaceuticals used are 11C-Choline, 68Ga-PSMA and 18F-PSMA.  These radiopharmaceuticals either enter the phospholipid synthesis process (11C-Choline) which is usually increased in prostatic neoplasia or bind to membrane antigens overexpressed on the tumor surface (68Ga-PSMA and 18F-PSMA). The radioisotope (11C, 68Ga or 18F) emits the radioactive signal that is captured by the tomograph (PET/TC or PET/RM) and allows the presence and location of the tumor to be assessed.

When is this exam indicated?

It is used after radical prostatectomy or radiotherapy in case of PSA elevation and negative results in the traditional prostate pathology tests; it is also used for patients taking drug therapy for prostate neoplasia.

It is also used in pre-surgical stage detection for patients with a confirmed diagnosis of prostate cancer (68Ga-PSMA and 18F-PSMA).

  • prostatic neoplasm

How is it performed?

Fasting for at least 4-6 hours is required prior to this examination. For a whole-body PET with 11C-Choline, the time spent in the department is about 45-60 minutes.  The 11C-Choline radiopharmaceutical is injected intravenously and after about 5 minutes the patient is placed in a supine position on the PET/CT or PET/RM scanner bed, remaining still during the examination and breathing calmly. The examination lasts approximately 30 minutes.

For a whole-body PET with 68Ga-PSMA and 18F-PSMA , the time spent in the department is approximately 2-3 hours. The 68Ga-PSMA or 18F-PSMA radiopharmaceutical is injected intravenously and after 60-120 minutes the patient is placed on the PET/TC or PET/RM tomograph couch in a supine position, remaining motionless during the procedure and breathing quietly. The examination lasts approximately 20-30 minutes. The recommended separation period from pregnant women and small children is the day of the examination.

The PET examination can be integrated with CT with contrast medium or MRI with contrast medium for diagnostic purposes, which requires the presence of the radiologist.

Both for PET with 11C-Choline and for those with 68Ga-PSMA and 18F-PSMA, at the time of the examination appointment it is necessary to provide a recent PSA level and on the day of the procedure it is required to provide the documentation of the clinical history and previous diagnostic examinations performed (PSA level, biopsies, CT, transrectal ultrasound, bone scintigraphy, PET, pelvic MRI, etc.).

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None. No contraindications or colalteral effects are known.

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