Correlation between choline kinase alpha expression and ¹¹C-choline accumulation in breast cancer using positron emission tomography/computed tomography: a retrospective study

Choline kinase (CK) is reportedly overexpressed in various malignancies. Among its isoforms, CK alpha overexpression is presumably related to oncogenic change. Choline positron emission tomography (PET) is reportedly useful for detecting and evaluating therapy outcomes in malignancies. In this study, we investigated the correlation between CK alpha expression and C-11-choline accumulation in breast cancer cells. We also compared the CK alpha expression level with other pathological findings for investigating tumour activity. Fifty-six patients with breast cancer (mean age: 51 years) who underwent their first medical examination between May 2007 and December 2008 were enrolled. All the patients underwent C-11-choline PET/computed tomography imaging prior to surgery. The maximum standardised uptake value was recorded for evaluating C-11-choline accumulation. The intensity of CK alpha expression was classified using immunostaining. A significant correlation was observed between CK alpha expression and C-11-choline accumulation (P<0.0001). A comparison of breast cancer mortality demonstrated that strong CK alpha expression was associated with a shorter survival time (P<0.0001). C-11-choline accumulation was also negatively correlated with survival time (P<0.0001). Tumours with strong CK alpha expression are reportedly highly active in breast cancer. A correlation was observed between CK alpha expression and C-11-choline accumulation, suggesting their role as prognostic indicators of breast cancer.