Overview

A choline C-11 PET scan is an imaging test that uses a radioactive tracer to look for fast-growing cells in the body, including cancer cells. This test most often is used to find prostate cancer that comes back after treatment.

A choline C-11 PET scan is a kind of positron emission tomography scan, also called PET scan. A PET scan uses a radioactive tracer that's injected into a vein. The tracer has a substance that helps it stick to the cells the test is looking for. A camera detects the places where the tracer builds up in the body.

In a choline C-11 PET scan, the tracer uses a radioactive form of the vitamin choline. Prostate cancer cells and some other fast-growing cells absorb more choline than other cells do. This helps the healthcare team find the cells they are looking for anywhere in the body.

Often a choline C-11 PET scan is combined with another kind of imaging test. The images may be taken at the same time by the same machine. A PET scan may be combined with a computerized tomography scan, also called a CT scan, or with magnetic resonance imaging, also called MRI. These other imaging tests make detailed pictures of the body. When the images are combined with choline C-11 PET images, healthcare teams can see the precise spots where the cells they are looking for are located.

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Why it's done

A choline C-11 PET scan looks for cancer cells and other fast-growing cells in the body. Most often, it's done to find prostate cancer that comes back after treatment, which is sometimes called recurrent prostate cancer. A choline C-11 PET scan might be used if other imaging tests haven't been helpful in finding the cancer.

Researchers also are studying other ways to use choline C-11 PET scans. This test has shown promise in finding overactive parathyroid glands. Parathyroid glands are found behind the thyroid at the bottom of the neck. They make parathyroid hormone, which helps keep the right balance of calcium in the body. Sometimes one or more of the glands make too much parathyroid hormone. This condition is called hyperparathyroidism. Studies show that choline C-11 PET scans might help find overactive parathyroid glands when other imaging tests can't.

Risks

A choline C-11 PET scan is a safe imaging test. Like all tests, it has some risks. These include:

  • A mild reaction at the place where the radioactive tracer goes into the arm.
  • Allergic reaction to the radioactive tracer.
  • Exposure to radiation from the tracer.
  • False-negative result. This can happen if cancer is present but the test doesn't detect it.
  • False-positive result. This can happen if the scan detects something that looks like cancer, but further testing finds that it isn't cancer.

How you prepare

If your healthcare team gives you instructions to help you prepare for a choline C-11 PET scan, follow them carefully. You may be asked to:

  • Stop eating for a few hours before the test.
  • Drink plenty of liquids, such as water, for a few hours before the test.

What you can expect

During a choline C-11 PET scan, you receive an injection in your arm and then have an imaging test.

A healthcare professional injects a radioactive tracer into a vein in your arm. The tracer is a radioactive form of the vitamin choline.

After the injection, you'll have a positron emission tomography scan, also called a PET scan. During the scan you lie on a table. The table slowly moves into the center of the imaging machine. The machine takes images of the body.

Often the same machine does a CT scan at the same time. Sometimes a choline C-11 PET scan is done by a machine that also makes MRI pictures.

Once the imaging tests are complete, you can go about your day. Your healthcare team might recommend that you empty your bladder as soon as you can after the test. This helps clear the radioactive tracer from the body.

Results

Ask your healthcare team when you can expect to know the results of your choline C-11 PET scan. This imaging test shows places in the body that absorb the radioactive tracer. Places that absorb the tracer may be cancer or another condition that causes cells to grow quickly. Sometimes other imaging tests or procedures might be needed to be sure.

March 14, 2025
  1. Choline C 11 Injection (prescribing information). Mayo Clinic PET Radiochemistry Facility; 2024. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=203155. Accessed Dec. 3, 2024.
  2. Saha S, et al. C11 choline PET/CT succeeds when conventional imaging for primary hyperparathyroidism fails. Surgery. 2023; doi:10.1016/j.surg.2022.08.024.
  3. PET/CT. RadiologyInfo.org. https://www.radiologyinfo.org/en/info/pet. Accessed Nov. 4, 2024.
  4. Prostate cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459. Accessed Nov. 3, 2024.
  5. Choline C 11 Injection (approval letter). New Drug Application 203155. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=203155. Accessed Dec. 4, 2024.
  6. Evans JD, et al. Prostate cancer-specific PET radiotracers: A review on the clinical utility in recurrent disease. Practical Radiation Oncology. 2018; doi:10.1016/j.prro.2017.07.011.
  7. Murphy RC, et al. The utility of 11C-choline PET/CT for imaging prostate cancer: A pictorial guide. American Journal of Roentgenology. 2011; doi:10.2214/AJR.10.5491.
  8. Parvinian A, et al. 11C-choline PET/CT for detection and localization of parathyroid adenomas. American Journal of Roentgenology. 2018; doi:10.2214/AJR.17.18312.
  9. Primary hyperparathyroidism. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/endocrine-diseases/primary-hyperparathyroidism. Accessed Dec. 20, 2024.

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