31. Clinical Application of [C-11]acetate in Oncology

Liu, R.S.

doi:10.1016/s1095-0397(00)00097-2

Cited by 18 publications

(5 citation statements)

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“…Acetyl-CoA is incorporated into cholesterol and fatty acids and therefore 11 C-Acetate uptake is an indirect biomarker of fatty acid synthesis. Data suggests that 11 C-Acetate PET/CT imaging is useful in malignancies(11) including PCa (12–13). It has been suggested that since PCa relies more on fatty acid metabolism than on glycolysis (14), 11 C-Acetate may be a more appropriate imaging agent than FDG (15).…”

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confidence: 99%

¹¹C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

Mena¹,

Türkbey²,

Mani³

et al. 2012

J Nucl Med

110

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This work characterizes the uptake of 11C-Acetate in prostate cancer (PCa), benign prostate hyperplasia (BPH) and normal prostate tissue in comparison with multi-parametric MRI, whole mount histopathology and clinical markers, to evaluate its potential utility for delineating intra-prostatic tumors in a population of patients with localized PCa. METHODS 39 men with presumed localized PCa underwent dynamic/static abdomen-pelvic 11C-Acetate PET/CT for 30-minutes and 3T multi-parametric (MP) MRI prior to prostatectomy. PET/CT images were registered to MRI using pelvic bones for initial rotation-translation, followed by manual adjustments to account for prostate motion and deformation from the MRI endorectal coil. Whole-mount pathology specimens were sectioned using an MRI-based patient specific mold resulting in improved registration between the MRI, PET and pathology. 11C-Acetate PET standardized uptake values were compared with MP-MRI and pathology. RESULTS 11C-Acetate uptake was rapid but reversible, peaking at 3–5 minutes post-injection and reaching a relative plateau at ~10 minutes. The average SUVmax(10–12min) of tumors was significantly higher than that of normal prostate tissue (4.4±2.05, range 1.8–9.2 vs. 2.1±0.94, range 0.7–3.4; p<0.001); however it was not significantly different from benign prostatic hyperplasia (4.8±2.01; range 1.8–8.8). A sector-based comparison with histopathology, including all tumors > 0.5 cm, revealed a sensitivity and specificity of 61.6 % and 80.0 % for 11C-Acetate PET/CT, and 82.3% and 95.1% for MRI, respectively. Considering only tumors >0.9 cm the 11C-Acetate accuracy was comparable to that of MRI. In a small cohort (n=9), 11C-Acetate uptake was independent of fatty acid synthase expression based on immunohistochemistry. CONCLUSION 11C-Acetate PET/CT demonstrates higher uptake in tumor foci than normal prostate tissue; however 11C-Acetate uptake in tumors is similar to BPH nodules. While 11C-Acetate PET/CT is not likely to have utility as an independent modality for evaluation of localized PCa, the high uptake in tumors may make it useful for monitoring focal therapy, where tissue damage after therapy may limit anatomic imaging methods.

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confidence: 99%

¹¹C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

Mena¹,

Türkbey²,

Mani³

et al. 2012

J Nucl Med

110

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“…11 C-acetate is a relatively new tracer for prostate cancer staging with molecular properties reflecting the pattern of lipid metabolism. It could potentially be used for other slow growing cancers apart from prostate cancer such as highly differentiated hepatocellular carcinoma (HCC), renal cell carcinoma (RCC), bladder carcinoma and brain tumours [ 27 , 28 ]. In our material of 50 patients, we found one histology-verified RCC and one HCC, thus supporting previous studies.…”

Section: Discussionmentioning

confidence: 99%

11C-acetate PET/CT in pre-therapeutic lymph node staging in high-risk prostate cancer patients and its influence on disease management - a retrospective study

et al. 2014

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BackgroundRadiation treatment with simultaneous integrated boost against suspected lymph node metastases may be a curative therapeutic option in patients with high-risk prostate cancer (>15% estimated risk of pelvic lymph node metastases according to the Cagiannos nomogram). 11C-acetate positron emission tomography/computed tomography (PET/CT) can be used for primary staging as well as for detection of suspected relapse of prostate cancer. The aims of this study were to evaluate the association between positive 11C-acetate PET/CT findings and the estimated risk of pelvic lymph node metastases and to assess the impact of 11C-acetate PET/CT on patient management in high-risk prostate cancer patients.MethodsFifty consecutive prostate cancer patients referred for primary staging with 11C-acetate PET/CT prior to radiotherapy with curative intention were enrolled in this retrospective study.ResultsAll patients showed increased 11C-acetate uptake in the prostate. Pelvic lymph node uptake was seen in 42% (21/50) of the patients, with positive external iliac lymph nodes in 71% (15/21) of these. The overall observed proportion of PET/CT-positive pelvic lymph nodes at patient level was higher than the average estimated risk, especially in low-risk groups (<15%). There was a significant association between observed proportion and estimated risk of pelvic lymph node metastases in groups with ≤45 and >45% estimated risk. Treatment strategy was altered due to 11C-acetate PET/CT findings in 43% (20/47) of the patients.ConclusionsThe observed proportion of 11C-acetate PET/CT findings suggestive of locoregional metastases was higher than the estimated risk, suggesting that the Cagiannos nomogram underestimates the risk for metastases. The imaging results with 11C-acetate PET/CT have a considerable impact on patient management.

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“…More recently, acetate-PET has been used in oncology too, for the assessment of some tumours, such as prostate cancer, renal cell carcinoma or HCC, in which FDG-PET is of limited use [55–57]. In those tumours, there is an increased uptake of 11C-acetate related to the over-expression of fatty acid synthetase, a key enzyme that entraps 11C-acetyl-CoA within different cellular structures and pathways [58].…”

Section: Lipid Synthesis and Energetic Metabolismmentioning

confidence: 99%

Imaging with non-FDG PET tracers: outlook for current clinical applications

et al. 2010

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Apart from the historical and clinical relevance of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG), various other new tracers are gaining a remarkable place in functional imaging. Their contribution to clinical decision-making is irreplaceable in several disciplines. In this brief review we aimed to describe the main non-FDG PET tracers based on their clinical relevance and application for patient care.

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31. Clinical Application of [C-11]acetate in Oncology

Cited by 18 publications

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¹¹C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

¹¹C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

11C-acetate PET/CT in pre-therapeutic lymph node staging in high-risk prostate cancer patients and its influence on disease management - a retrospective study

Imaging with non-FDG PET tracers: outlook for current clinical applications

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31. Clinical Application of [C-11]acetate in Oncology

Cited by 18 publications

References 0 publications

11C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

11C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

11C-acetate PET/CT in pre-therapeutic lymph node staging in high-risk prostate cancer patients and its influence on disease management - a retrospective study

Imaging with non-FDG PET tracers: outlook for current clinical applications

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¹¹C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation

¹¹C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation