(11)C-acetate PET in the early evaluation of prostate cancer recurrence

Eur J Nucl Med Mol Imaging. 2007 Feb;34(2):185-96. doi: 10.1007/s00259-006-0163-x. Epub 2006 Jul 11.

Abstract

Purpose: The first aim of the study was to investigate the diagnostic potential of (11)C-acetate PET in the early detection of prostate cancer recurrence. A second aim was the evaluation of early and late PET in this context.

Methods: The study population comprised 32 prostate cancer patients with early evidence of relapse after initial radiotherapy (group A) or radical surgery (group B). The median PSA of group A (n=17) patients was 6 ng/ml (range 2.6-30.2) while that of group B (n=15) was 0.4 ng/ml (range 0.08-4.8). Pelvic-abdominal-thoracic PET was started 2 min after injection of (11)C-acetate and evaluated after fusion with CT.

Results: Group A: Taking a SUV(max)> or =2 as the cut-off, PET showed local recurrences in 14/17 patients and two equivocal results. Distant disease was observed in six patients and an equivocal result was obtained in one. Endorectal MRI was positive in 12/12 patients. Biopsy confirmed local recurrence in six of six (100%) patients. PET was positive in five of the six patients with biopsy-proven recurrences, the result in the remaining patient being equivocal. Group B: Among the 15 patients, visual interpretation was positive for local recurrences in five patients and equivocal in four. One obturator lymph node was positive. Endorectal MRI was positive in 11/15 patients and equivocal in two. Positional correlation of positive/equivocal results on PET and endorectal MRI was observed in seven of nine patients. PSA decreased significantly after salvage radiotherapy in 8/14 patients, providing strong evidence for local recurrence. PET of the eight patients responding to RT was positive in three and equivocal in two.

Conclusion: (11)C-acetate PET was found to be valuable in the early evaluation of prostate cancer relapse. Optimising scanning time and use of modern PET-CT equipment might allow further improvement.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Acetates*
  • Aged
  • Carbon*
  • Clinical Trials as Topic
  • Humans
  • Image Enhancement / methods*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / prevention & control*
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / therapy*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • Acetates
  • Radiopharmaceuticals
  • carbon-11 acetate
  • Carbon