<sup>11</sup>C-Acetate Positron Emission Tomography Imaging and Image Fusion With Computed Tomography and Magnetic Resonance Imaging in Patients With Recurrent Prostate Cancer

Wachter, Stefan De; Tomek, Sandra; Kurtaran, Amir; Wachter-Gerstner, Natascha; Djavan, Bob; Becherer, Alexander; Mitterhauser, Markus; Dobrozemsky, Georg; Li, S.; Pötter, Richard; Dudczak, Robert; Kletter, Kurt

doi:10.1200/jco.2005.03.5279

Cited by 108 publications

(68 citation statements)

References 23 publications

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“…Unfortunately, the most commonly available tracer, 18 F-labeled glucose ( 18 F-FDG), has a low sensitivity for cancer detection (7). Although preliminary studies have demonstrated that 11 C-acetate is a promising tracer for diagnosis of recurrent (8)(9)(10) or metastatic (11) prostate cancer, its use in primary diagnosis is less well established. In particular, the clinical role of 11 C-acetate in prostate cancer detection and staging is currently unclear (12,13).…”

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confidence: 99%

Functional Imaging of Localized Prostate Cancer Aggressiveness Using ¹¹C-Acetate PET/CT and ¹H-MR Spectroscopy

Jambor¹,

Borra²,

Kemppainen³

et al. 2010

J Nucl Med

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We assessed the ability of 11 C-acetate PET/CT, MRI, and proton MR spectroscopy ( 1 H-MRS) to image localized prostate cancer and detect its aggressiveness, using qualitative and quantitative approaches. Methods: Twenty-one patients with untreated localized prostate cancer, diagnosed using transrectal ultrasound-guided biopsy, were prospectively enrolled. Cancer laterality was based on the percentage of cancer and the highest Gleason score determined from biopsies. In addition to PET/CT, 3-dimensional 1 H-MRS of the entire prostate volume using a quantitative approach was performed. The imaging and histologic findings of 8 patients undergoing subsequent prostatectomy were compared on a sextant level. For each lobe and sextant, standardized uptake values (SUVs) and (choline 1 creatine 1 polyamines)-to-citrate (CCP/C) ratios were obtained from 11 C-acetate PET/CT and 1 H-MRS, respectively. The visual and quantitative findings on PET/CT and MRI data were compared with cancer laterality and aggressiveness based on the Gleason score and with prostate-specific antigen (PSA) velocity and international risk group classification. Results: The sensitivity, specificity, and accuracy, on a lobar level using visual analysis, of 11 C-acetate PET/CT were 80%, 29%, 71%, respectively, and 89%, 29%, 79%, respectively, using contrastenhanced MRI. The sensitivity and accuracy of 11 C-acetate PET/CT decreased to 64% and 63% and specificity increased to 62% when sextant analysis was performed. The agreement between prostate cancer laterality based on biopsy findings and visual interpretation of 11 C-acetate PET/CT and contrastenhanced MRI was similar at 71%. The mean SUV maximum and CCP/C maximum for the dominant tumor lesion were 5.5 and 1.48, respectively, and did not differ significantly from values in the nondominant lobe. The dominant-lesion SUVs or CCP/C values were not associated with histologically determined prostate cancer aggressiveness, nor did PSA velocity correlate with the SUV or CCP/C values from the entire gland.Conclusion: 11 C-acetate PET/CT, MRI, and 1 H-MRS enable detection of localized prostate cancer with comparable and limited accuracy but fail to provide information on cancer aggressiveness.

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confidence: 99%

Functional Imaging of Localized Prostate Cancer Aggressiveness Using ¹¹C-Acetate PET/CT and ¹H-MR Spectroscopy

Jambor¹,

Borra²,

Kemppainen³

et al. 2010

J Nucl Med

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“…The most common tracer, 2 [ 18 F]fluoro-2-deoxy-D-glucose (FDG), has a low sensitivity for detecting early prostate cancer due to the low glucose consumption (9,10), limiting the possibility to detect clinically localized disease. Other tracers, such as 18 F-or 11 C-labeled choline and [ 11 C]-acetate, are used mainly for the diagnosis of recurrent (11)(12)(13) or metastatic (14) prostate cancer. Their feasibility in primary diagnosis is limited because of uptake in benign tissue such as benign prostatic hyperplasia (BPH; refs.…”

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confidence: 99%

In Vivo Imaging of Prostate Cancer Using [68Ga]-Labeled Bombesin Analog BAY86-7548

Kähkönen

Jambor

Kemppainen

et al. 2013

Clinical Cancer Research

177

164

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Purpose: A novel [68 Ga]-labeled DOTA-4-amino-1-carboxymethyl-piperidine-D-Phe-Gln-Trp-Ala-ValGly-His-Sta-Leu-NH 2 peptide (BAY86-7548) having high affinity to bombesin receptor subtype II to detect primary and metastatic prostate carcinoma using positron emission tomography/computed tomography (PET/CT) was synthesized and evaluated for prostate cancer. Experimental Design: In this first human study with BAY86-7548, 14 men scheduled for radical prostatectomy (n ¼ 11) or with biochemical recurrence after surgery or hormonal therapy (n ¼ 3) were enrolled. The patients received an intravenous injection of BAY86-7548 followed by over 60-minute dynamic imaging of prostate gland (n ¼ 10) and/or subsequent whole-body imaging (n ¼ 14). The visual assessment of PET/CT images included evaluation of intraprostatic (12 subsextants) and pelvic nodal uptake of BAY86-7548 in 11 surgical patients and detection of potential metastatic foci in all patients. In patients with biochemical recurrence, results were compared with those of eitherWe found a sensitivity, specificity, and accuracy of 88%, 81% and 83%, respectively, for detection of primary PCa and sensitivity of 70% for metastatic lymph nodes using histology as gold standard. BAY86-7548 correctly detected local recurrence in prostate bed and showed nodal relapse in accordance with

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“…11 C-acetate, 11 C-choline, and 18 F-choline have been reported to be useful for the diagnosis of recurrent or metastatic prostate cancer (4)(5)(6)(7)(8). However, the very short half-life of 11 C limits its use to facilities equipped with a cyclotron.…”

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Pilot Comparison of ⁶⁸Ga-RM2 PET and ⁶⁸Ga-PSMA-11 PET in Patients with Biochemically Recurrent Prostate Cancer

et al. 2015

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Glu-NH-CO-NH-Lys-(Ahx)-[ 68 Ga(HBED-CC)] ( 68 Ga-PSMA-11) is a PET tracer that can detect prostate cancer relapses and metastases by binding to the extracellular domain of PSMA. 68 Ga-labeled DOTA-4-amino-1-carboxymethyl-piperidine-D-Phe-Gln-Trp-AlaVal-Gly-His-Sta-Leu-NH2 ( 68 Ga-RM2) is a synthetic bombesin receptor antagonist that targets gastrin-releasing peptide receptors. We present pilot data on the biodistribution of these PET tracers in a small cohort of patients with biochemically recurrent prostate cancer. Methods: Seven men (mean age ± SD, 74.3 ± 5.9 y) with biochemically recurrent prostate cancer underwent both 68 Ga-PSMA-11 PET/ CT and 68 Ga-RM2 PET/MRI scans. SUV max and SUV mean were recorded for normal tissues and areas of uptake outside the expected physiologic biodistribution. Results: All patients had a rising level of prostate-specific antigen (mean ± SD, 13.5 ± 11.5) and noncontributory results on conventional imaging. 68 Ga-PSMA-11 had the highest physiologic uptake in the salivary glands and small bowel, with hepatobiliary and renal clearance noted, whereas 68 Ga-RM2 had the highest physiologic uptake in the pancreas, with renal clearance noted. Uptake outside the expected physiologic biodistribution did not significantly differ between 68 Ga-PSMA-11 and 68 Ga-RM2; however, 68 Ga-PSMA-11 localized in a lymph node and seminal vesicle in a patient with no abnormal 68 Ga-RM2 uptake. Abdominal periaortic lymph nodes were more easily visualized by 68 Ga-RM2 in two patients because of lack of interference by radioactivity in the small intestine. Conclusion: 68 Ga-PSMA-11 and 68 Ga-RM2 had distinct biodistributions in this small cohort of patients with biochemically recurrent prostate cancer. Additional work is needed to understand the expression of PSMA and gastrinreleasing peptide receptors in different types of prostate cancer.

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¹¹C-Acetate Positron Emission Tomography Imaging and Image Fusion With Computed Tomography and Magnetic Resonance Imaging in Patients With Recurrent Prostate Cancer

Abstract: Retrospective fusion of AC PET and CT/MRI is feasible and seems to be essential for final diagnosis. This is particularly true in patients with AC uptake in the prostate region.

Cited by 108 publications

References 23 publications

Functional Imaging of Localized Prostate Cancer Aggressiveness Using ¹¹C-Acetate PET/CT and ¹H-MR Spectroscopy

Functional Imaging of Localized Prostate Cancer Aggressiveness Using ¹¹C-Acetate PET/CT and ¹H-MR Spectroscopy

In Vivo Imaging of Prostate Cancer Using [68Ga]-Labeled Bombesin Analog BAY86-7548

Pilot Comparison of ⁶⁸Ga-RM2 PET and ⁶⁸Ga-PSMA-11 PET in Patients with Biochemically Recurrent Prostate Cancer

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11C-Acetate Positron Emission Tomography Imaging and Image Fusion With Computed Tomography and Magnetic Resonance Imaging in Patients With Recurrent Prostate Cancer

Abstract: Retrospective fusion of AC PET and CT/MRI is feasible and seems to be essential for final diagnosis. This is particularly true in patients with AC uptake in the prostate region.

Cited by 108 publications

References 23 publications

Functional Imaging of Localized Prostate Cancer Aggressiveness Using 11C-Acetate PET/CT and 1H-MR Spectroscopy

Functional Imaging of Localized Prostate Cancer Aggressiveness Using 11C-Acetate PET/CT and 1H-MR Spectroscopy

In Vivo Imaging of Prostate Cancer Using [68Ga]-Labeled Bombesin Analog BAY86-7548

Pilot Comparison of 68Ga-RM2 PET and 68Ga-PSMA-11 PET in Patients with Biochemically Recurrent Prostate Cancer

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¹¹C-Acetate Positron Emission Tomography Imaging and Image Fusion With Computed Tomography and Magnetic Resonance Imaging in Patients With Recurrent Prostate Cancer

Functional Imaging of Localized Prostate Cancer Aggressiveness Using ¹¹C-Acetate PET/CT and ¹H-MR Spectroscopy

Functional Imaging of Localized Prostate Cancer Aggressiveness Using ¹¹C-Acetate PET/CT and ¹H-MR Spectroscopy

Pilot Comparison of ⁶⁸Ga-RM2 PET and ⁶⁸Ga-PSMA-11 PET in Patients with Biochemically Recurrent Prostate Cancer