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Evaluation at Mayo Clinic

Mayo Gets FDA Approval for New Imaging Agent for Recurrent Prostate Cancer: Urology

Eugene D. Kwon, M.D., explains the value of Choline C-11 PET scan test.

Mayo Gets FDA Approval for New Imaging Agent for Recurrent Prostate Cancer: Radiology

Val Lowe, M.D., discusses how the Choline C-11 imaging agent works.

You must complete an initial evaluation in the Department of Urology before being considered for the Choline C-11 PET scan. Following the consult, a determination will be made regarding the appropriateness of the scan. If the Choline C-11 PET scan is recommended, a separate return visit will likely be required to conduct the scan. Access for this scan is limited by the ability to produce the Choline C-11 imaging agent and appointment availability.

The local contractor for the Centers for Medicare & Medicaid Services (CMS) has approved coverage of this scan for the indications of recurrent prostate cancer and biochemical recurrence of prostate cancer.

What to expect during your Choline C-11 PET scan

Early warning system for recurrent prostate cancer.

Click here for an infographic to learn more

If it's determined that you're a candidate, you'll receive a full-body positron emission tomography (PET) scan using Choline C-11 Injection. At Mayo Clinic, you'll also receive a computerized tomography (CT) scan at the same time.

The entire scanning procedure — including preparation time — takes about an hour.

To prepare, you'll be asked to lie on your back on a movable table. You'll likely be strapped onto the table to help keep you from moving during the scan. You can wear your street clothes and small jewelry.

Just before the PET and CT scans, you'll receive the Choline C-11 agent through an injection in a vein in your arm. The table on which you're lying will then move into the scanner and the exam will begin.

The actual Choline C-11 PET scan and accompanying CT scan usually take about 20 minutes. After 20 minutes, the Choline C-11 agent degrades and is no longer useful in identifying sites of possible recurrent prostate cancer. During the scan, you may listen to music to help you relax.

When the scan is complete, the table moves out of the scanner, and you'll be free to leave. You can resume your daily activities. Your doctor will meet with you to discuss the results of your scan.

Possible risks associated with the Choline C-11 PET scan include imaging errors, allergic reaction to the imaging agent and mild injection site reactions. A Choline C-11 PET scan also contributes to your long-term cumulative radiation exposure.

Read the full prescribing information for Choline C-11 Injection.

The Mayo Clinic experience and patient stories

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients.

  1. New Imaging Technology Inspires One Couple to Invest in Mayo Clinic

    After John Sullivan experienced the benefits of a Choline C-11 PET scan when he had a recurrence of prostate cancer, he and his fianc?e, Sheri Butler, were motivated to become benefactors and advocates for the expansion of Mayo Clinic's Florida campus. The future is clear for John Sullivan of Ocala, Florida, and his fianc?e, Sheri [...]

Expertise and rankings

Mayo Clinic prostate cancer specialists draw on their expertise and experience to provide you with exactly the care you need.

  • Earlier detection of recurrent prostate cancer sooner. Choline C-11 PET scan can help doctors detect recurrent prostate cancer before it may be detected by more-conventional imaging tests.

    In men with rising prostate-specific antigen (PSA) levels, this test may help detect sites of possible recurrent prostate cancer at PSA levels as low as 2 nanograms per milliliter (ng/mL). Conventional tests may not detect a recurrence until PSA levels are greater than 20 ng/mL. This could mean detecting sites of cancer recurrence months or years in advance.

  • FDA-approved Choline C-11 PET scan site. Mayo Clinic's campus in Rochester, Minnesota, was the first medical center in the United States to receive approval by the Food and Drug Administration (FDA) to prepare and administer the Choline C-11 PET scan imaging agent (Choline C-11 Injection).
  • Helps identify areas of active recurrent prostate cancer after all forms of treatment. Previous treatment may leave scar tissue that can be confused with active cancer when viewed using conventional imaging. Choline C-11 PET scan can help doctors distinguish between scar tissue, inactive cancer cells and active, recurrent prostate cancer.
  • Collaboration. At Mayo Clinic, an expert team of urologists, medical oncologists, radiation oncologists and other specialists, if needed, work together to provide you with exactly the care you need. Mayo Clinic specialists have extensive experience treating men with complex cases of recurrent prostate cancer.
  • Full range of treatments available. If Mayo Clinic doctors diagnose recurrent prostate cancer, you have many treatment options. These options may include radiation therapy, including highly focused stereotactic body radiation therapy, intensity-modulated radiation therapy and brachytherapy; hormone therapy; immunotherapy; surgery to remove the prostate (prostatectomy) and, if necessary, pelvic lymph nodes; cryosurgery; and chemotherapy.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Mayo Clinic in Rochester, Minn., Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

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Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

Jan. 03, 2018
  1. Choline C-11 injection (prescribing information). Rochester, Minn. Mayo Clinic PET Radiochemistry Facility; 2012. Accessed Oct. 12, 2015.
  2. Prostate cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. Accessed Oct. 12, 2015.
  3. Fanti S, et al. PET/CT with 11C-choline for evaluation of prostate cancer patients with biochemical recurrence: Meta-analysis and critical review of available data. European Journal of Nuclear Medicine and Molecular Imaging. In press. Accessed Oct. 12, 2015.
  4. Murphy RC, et al. The utility of 11C-choline PET/CT for imaging prostate cancer: A pictorial guide. American Journal of Roentgenology. 2011;196:1390.
  5. Fuccio C, et al. Choline PET/CT for prostate cancer: Main clinical applications. European Journal of Radiology. 2011;80:50.
  6. Fox JJ, et al. Molecular imaging of prostate cancer. Current Opinion in Urology. 2012;22:320.
  7. Kitajima K, et al. Update on positron emission tomography for imaging of prostate cancer. International Journal of Urology. 2014;21:12.
  8. Mitchell CR, et al. Operational characteristics of 11C-choline positron emission tomography/computerized tomography for prostate cancer with biochemical recurrence after initial treatment. The Journal of Urology. 2013;189:1308.