Muhammad Ali Chaudhry MBBS, Presenter: Nothing to Disclose

Richard L. Wahl MD, Abstract Co-Author: Research grant, General Electric Company License agreement, Naviscan PET Systems, Inc License agreement, GlaxoSmithKline plc License agreement, Cell Therapeutics, Inc Scientific Advisor, Cellectar, LLC Scientific Advisor, Actinium Pharmaceuticals, Inc Consultant, Cellectar, LLC Consultant, Nihon Medi-Physics Co, Ltd Stockholder, Threshold Pharmaceuticals, Inc

Lawrence Peter Shombert MD, Abstract Co-Author: Nothing to Disclose

The use of 18F-FDG in prostate cancer is limited due to low uptake by slow growing cancerous cells as well as significant physiological urinary excretion. C-11 acetate represents an alternative radiotracer for detection of prostate cancer with PET, measuring radiopharmaceutical uptake pathways, including membrane synthesis, that are different from those measured with F-18 FDG. In this abstract we are presenting preliminary results of our clinical experience with PET/CT imaging utilizing dual radiotracers i.e. C11-acetate and 18F-FDG in prostate cancer.  

Clinical patients with prostate cancer in whom traditional imaging was inconclusive underwent dual radiotracer PET/CT imaging utilizing C-11 acetate and 18F-FDG on the same day. A total of 26 studies in 26 patients (age range 40-84) were performed over a one year period from 03/2008-03/2009. Clinical information is currently available for 25 patients.  

8 out of 25 patients (age range 40-75) were referred for staging, while, 17/25 patients were referred for restaging with a clinical suspicion and/or biochemical evidence of recurrence. In the staging population, C-11 acetate imaging was positive in 6/8 patients in identifying a primary prostate cancer. By contrast, 18F-FDG was falsely negative in 7/8 studies while correctly identifying intraprostatic disease in only 1 patient. In addition, C-11 acetate imaging was able to detect apparent nodal disease in 1 staging patient, while, 18F-FDG was negative in all 8 staging studies. 17 patients (age range 50-84) were referred for re-staging. C-11 acetate imaging was positive in identifying apparent local recurrence in the prostate bed in 6/17 patients, while, 18F-FDG imaging was negative in all 17 patients. C-11 acetate positively identified apparent nodal spread of the disease in 5/17 patients while 18F-FDG was unable to detect any nodal disease.   

In our preliminary results, C-11 acetate PET/CT imaging has higher sensitivity compared to 18F-FDG imaging in detecting primary prostate cancer, local recurrence as well as apparent nodal spread of the disease in both the staging and re-staging patient populations. Clinical follow up is ongoing.  

Prostate cancer staging and re-staging can be improved with molecular imaging utilizing C-11 acetate PET/CT imaging.

Chaudhry, M, Wahl, R, Shombert, L, Role of Molecular Imaging with C-11 Acetate and 18F-FDG PET/CT in Prostate Cancer.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015083.html