Original article

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 34, Issue 2, pp 185-196

First online:

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

  • Susanne AlbrechtAffiliated withService of Nuclear Medicine, University Hospital of Geneva Email author 
  • , Franz BucheggerAffiliated withService of Nuclear Medicine, University Hospital of GenevaService of Nuclear Medicine, University Hospital of Lausanne
  • , Dmitri SolovievAffiliated withService of Nuclear Medicine, University Hospital of Geneva
  • , Habib ZaidiAffiliated withService of Nuclear Medicine, University Hospital of Geneva
  • , Hansjoerg VeesAffiliated withService of Radiation Oncology, University Hospital of Geneva
  • , Haleem G. KhanAffiliated withInstitute of Radiology Jean Violette
  • , Alain KellerAffiliated withService of Nuclear Medicine, University Hospital of Geneva
  • , Angelika Bischof DelaloyeAffiliated withService of Nuclear Medicine, University Hospital of Lausanne
  • , Osman RatibAffiliated withService of Nuclear Medicine, University Hospital of Geneva
    • , Raymond MiralbellAffiliated withService of Radiation Oncology, University Hospital of GenevaInstituto Oncológico Teknon

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Abstract

Purpose

The first aim of the study was to investigate the diagnostic potential of 11C-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 11C-acetate and evaluated after fusion with CT.

Results

Group A: Taking a SUVmax≥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

11C-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.

Keywords

11C-acetate PET Prostate cancer relapse PSA