carbon-11-acetate and Neoplasm-Metastasis

To evaluate the diagnostic accuracy of (11)C-acetate positron-emission tomography (PET) in the detection of bone metastasis in patients with prostate cancer with biochemical recurrence.. Ninety patients (100%) with rising prostate-specific antigen (PSA) levels (>0.2 ng/ml) after radical prostatectomy, who had both (11)C-acetate PET and bone scan performed and who had clinical follow-up/imaging follow-up for bone metastasis, considered a gold standard, were included. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for (11)C-acetate PET were calculated on a per-patient basis.. (11)C-Acetate PET and (99m)Tc-dicarboxypropane-diphosphonate findings were concordant in 84 (93.3%) patients [35 (38.9%) true-positive, 49 (54.4%) true-negative]. Discordant findings were observed in six patients (6.7%). (11)C-Acetate PET presented two (2.2%) false-positive and four (4.4%) false-negative findings. The sensitivity, specificity, PPV, and NPV for (11)C-acetate PET were 89.7%, 96.1%, 94.6%, and 92.2%, respectively. The median PSA of patients with multiple skeletal metastases (median=23.64 ng/ml, range=3.16-551.1 ng/ml) differed significantly (p=0.018) from that of patients with focal metastases (median=6.7 ng/ml, range=0.31-12.8 ng/ml).. (11)C-Acetate PET is a useful tool for patients with prostate cancer with biochemical recurrence, as it can depict multiple sites of recurrence and in particularly shows a high diagnostic value equivalent to that of bone scan for the detection of bone metastases.

Topics: Acetates; Bone Neoplasms; Carbon; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Retrospective Studies

To evaluate positron emission tomography with C11-acetate as a method for detecting and localizing prostate cancer recurrence. No technique for localizing and detecting prostate cancer recurrence after biochemical relapse available today is sensitive enough to localize recurrence at a stage at which salvage radiotherapy is still curative.. Twenty patients (age 56 to 77 years) who had undergone radical prostatectomy and had an increasing prostate-specific antigen level measured on two consecutive occasions were included. In addition to the investigations usually performed when prostate cancer recurrence is suspected, they underwent positron emission tomography with C11-acetate as the marker.. Pathologic uptake of acetate was seen in 15 (75%) of the 20 patients. In 8 of these patients, a solitary lesion was found (seven in the prostatic fossa and one at the regional lymph nodes). Multiple lesions were found in the remaining 7. False-positive uptake was seen in 3 men (15%). Additional investigations in these men revealed pathologic findings other than prostate cancer.. Positron emission tomography with C11-acetate as marker is a promising method for early detection and localization of prostate cancer recurrence. False-positive uptake does occur.

Topics: Acetates; Aged; Biomarkers, Tumor; Carbon; Carbon Radioisotopes; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Pilot Projects; Positron-Emission Tomography; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms