Figure 2.

(A–D) Sequential images (MIP) of [¹⁸F]FCH PET/CT scan from a patient with multiple metastatic prostate cancer. (A) There were multiple bone metastases predominantly in the axial skeleton. He received 3 cycles of [²²³Ra]RaCl; (B) The PSA was increasing (more than 150%) after 3 cycles of [²²³Ra]RaCl. He finished 6 cycles of [²²³Ra]RaCl therapy. He became pain-free and ceased to take analgesic medication; (C) The metabolism imaging showed rather stable metabolic disease although the PSA level was slightly increased; (D) After 8 months of follow-up, there was an aggressive anatomic, metabolic and biochemical progression of the disease. Regarding the previous and slow disease progression under [²²³Ra]RaCl, he was recommended to receive the 2nd course of [²²³Ra]RaCl treatment/palliation. [¹⁸F]FCH PET/CT—[¹⁸Fluorine] fluorocholine positron emission tomography/computed tomography; MIP—maximum intensity projection; PSA—prostate-specific antigen; [²²³Ra]RaCl—[²²³radium]ra-dichloride.