Combined use of F-18 fluorocholine positron emission tomography and magnetic resonance spectroscopy for brain tumor evaluation

J Neuroimaging. 2004 Jul;14(3):285-9. doi: 10.1177/1051228404264957.


Background: Choline metabolism is often abnormal in malignant brain tumors.

Methods: Brain positron emission tomography (PET) imaging with F-18 fluorocholine (FCH) was performed on 2 patients with intracranial lesions suspected to be high-grade malignant gliomas on the basis of magnetic resonance (MR) imaging and multivoxel 1H-MR spectroscopic imaging (MRSI) findings. Standardized uptake value (SUV) measurements on PET were compared with measurements of choline/creatine metabolite ratio on MRSI in corresponding regions. Brain biopsy revealed glioblastoma multiforme (GBM) in one case and demyelinating disease in the other.

Results: In the case of GBM, the tumor demonstrated increased FCH uptake on PET. The mean and maximum SUV in areas of the tumor correlated with regional choline/creatine ratio measurements (r = 0.76, P < .001; r = 0.83, P < .001, respectively). In the case of tumefactive demyelinating lesions, the lesion demonstrated low FCH uptake, which did not correlate with choline/creatine ratio measurements.

Conclusions: Assessments of choline metabolism may aid in evaluating intracranial mass lesions.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Brain / metabolism
  • Brain Neoplasms / diagnosis*
  • Choline / analogs & derivatives*
  • Demyelinating Diseases / diagnosis
  • Female
  • Fluorine Radioisotopes
  • Glioblastoma / diagnosis*
  • Humans
  • Magnetic Resonance Spectroscopy*
  • Middle Aged
  • Radiopharmaceuticals
  • Tomography, Emission-Computed*


  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Choline