Application of 11C-CHO in the imaging of cerebral alveolar echinococcosis: A prospective study

11C-acetylcholine (11C-CHO) is a positron emission tomography (PET) radiotracer that has been utilized in the diagnosis and treatment of prostate, esophageal, and lung cancers. This preliminary study aimed to assess the feasibility of using 11C-CHO PET/computed tomography (CT) for imaging cerebral alveolar echinococcosis (CAE). In a prospective single-center study, patients with CAE underwent 18F-fludeoxyglucose (18F-FDG) and 11C-CHO PET/CT imaging. The number and location of lesions detected by the 2 tracers were compared, along with determining the maximum standard uptake value (SUVmax) of the lesions and the SUVmax values of the lesions/contralateral normal brain tissue (T/NT values). A total of 35 lesions (mean 4.3 lesions) in 8 CAE patients were imaged using both 18F-FDG and 11C-CHO PET/CT. The findings demonstrated that 11C-CHO PET/CT successfully detected all 35 lesions, achieving a 100% accuracy rate. This contrasted with the performance of 18F-FDG PET/CT, which only identified 24 lesions, resulting in an accuracy rate of 68.57%. Quantitative analysis further indicated that the SUVmax for 11C-CHO PET/CT averaged 3.13±0.93, compared to 9.35±2.84 for 18F-FDG PET/CT. The results of this study highlight the potential of 11C-CHO PET/CT as a novel imaging technique for CAE. In comparison to conventional 18F-FDG PET/CT, 11C-CHO PET/CT demonstrates superior accuracy in lesion detection, suggesting enhanced diagnostic capabilities and potential improvements in patient follow-up. Moving forward, conducting additional clinical studies will be crucial to corroborate and expand upon these promising findings.