====== 11C choline positron emission tomography ======

Five articles comprising 6 studies with total 118 patients (134 scans) were enrolled for a [[metaanalysis]]. There was no heterogeneity or [[publication]] [[bias]] among the included studies. The pooled [[sensitivity]] and [[specificity]] were 0.87 (95% [[confidence interval]] [CI]: 0.78, 0.93) and 0.820 (95% CI: 0.69, 0.91), respectively. The pooled diagnostic [[odds ratio]] was 35.50 (95% CI: 11.70, 107.75). The area under the curve was 0.9170 (95% CI: 0.8504, 0.9836), with Q* index equaling to 0.8499. The diagnostic accuracy of each subgroup showed no statistical differences with that of the overall group.

This meta-analysis indicated 11C-choline has high diagnostic accuracy for the identification of tumor [[relapse]] from [[radiation induced necrosis]] in [[glioma]]s
((Gao L, Xu W, Li T, Zheng J, Chen G. Accuracy of 11C-choline positron emission 
tomography in differentiating glioma recurrence from radiation necrosis: A
systematic review and meta-analysis. Medicine (Baltimore). 2018
Jul;97(29):e11556. doi: 10.1097/MD.0000000000011556. PubMed PMID: 30024551.
)).
----
The results of [[11C]]-[[choline]] [[positron emission tomography]] ([[PET]]) in 22 patients suspected of having brain tumours were compared with the findings of contrast-enhanced [[magnetic resonance]] (MR) [[imaging]] and [[fluorine 18]] [[fluorodeoxyglucose]] [[PET]]. A histopathological diagnosis was made for each patient during open surgery. The standardised uptake values of brain tumours and the tumour-to-white matter count (T/W) ratios were determined. The degree of 11C-choline accumulation noted in PET images was compared with the [[gadolinium]]-enhanced areas of [[MR]] images. The mean T/W ratio of 11C-choline in high-grade gliomas was found to be higher than that in low-grade gliomas. This difference was statistically significant (mean+/-SD: 8.7+/-6.2, n=9 versus 1.5+/-0.7, n=5, P<0.03) when data pertaining to the prominent uptake of 11C-choline in a patient with a [[pilocytic astrocytoma]] were excluded. 11C-choline PET failed to detect non-neoplastic lesions in two patients. Areas of 11C-choline accumulation in PET scans were larger than areas enhanced on MR images in five cases involving high-grade gliomas. 11C-choline PET differentiated between low-grade gliomas and high-grade gliomas, but did not differentiate between low-grade gliomas and non-neoplastic lesions. The combination of 11C-choline PET and MR imaging may provide investigators with an accurate means by which to identify [[high-grade glioma ]]s
((Ohtani T, Kurihara H, Ishiuchi S, Saito N, Oriuchi N, Inoue T, Sasaki T. Brain
tumour imaging with carbon-11 choline: comparison with FDG PET and
gadolinium-enhanced MR imaging. Eur J Nucl Med. 2001 Nov;28(11):1664-70. PubMed
PMID: 11702108.
)).

===== Epileptogenic foci =====

A new role of 11 C-Choline PET in localizing the epileptogenic foci in insular cortex in the patients
((Chen YF, Wei R, Yuan GQ, Gao DD, Jin Q, Cui XY, Zhang GX, Guo J. A new role of
(11) C-Choline PET in localizing the epileptogenic foci in insular cortex in the 
patients. CNS Neurosci Ther. 2019 Sep 11. doi: 10.1111/cns.13215. [Epub ahead of 
print] PubMed PMID: 31508896.
)).