Increased C-11 Choline Uptake in Pagetic Bone in a Patient With Coexisting Skeletal Metastases From Prostate Cancer

Positron emission tomography/computed tomography (PET/CT) with C-11 choline is currently used for restaging prostate cancer in patients with biochemical failure. Skeletal Paget disease can be associated with prostate cancer, and bone scintigraphy can differentiate the 2 conditions. We report the case of a 74-year-old patient with prostate cancer who displayed multiple areas skeletal uptake of C-11 choline on a restaging PET/CT, which was attributed to both metastatic and pagetic bone diseases. The pattern of C-11 choline uptake was different between the 2 conditions, probably in relation to the different mechanisms of disease. The possibility of C-11 choline uptake in pagetic bone should be kept in mind when interpreting PET/CT findings in patients with prostate cancer.