Cancer Treatment Today

FDG PET is not very sensitive in staging prostate cancer. Studies of C-11 suggest that it may be useful in the assessment of nasopharyngeal carcinoma, renal cell carcinoma, glial and meningeal brain tumors, and prostate cancer. C-11 acetate may accumulate more than FDG in prostate cancer; the reasons and modulating factors for this observation are unclear. Shreve and colleagues showed, in an in vitro study, that cellular retention of radiolabeled acetate in prostate cancer cell lines is primarily caused by incorporation of the radiocarbon into phosphatidylcholine and neutral lipids of the cells.

The lack of accumulation of acetate in urine is also advantageous to imaging prostate cancer, because the prostate bed remains unobstructed by the adjacent high levels of radioactivity in the urinary bladder, which is a common problem with FDG. More studies are required before teh role of this type of PET is more clearly defined in prostate cancer.

1. Shreve PD, Iannone P, Weinhold P. Cellular metabolism of [1-C14]-acetate in prostate cancer cells in vitro. J Nucl Med. 2002;43(5 suppl):272P.
2. Seltzer MA, Jahan S, Dahlbom M, et al. C-11 acetate PET imaging of primary and locally recurrent prostate cancer: comparison to normal controls. J Nucl Med. 2002;43(5 suppl):117P.
3. Schiepers C, Hoh CK, Seltzer M, et al. Quantification of dynamic PET studies in prostate cancer: which model applies for C-11 acetate? J Nucl Med. 2002;43(5 suppl):118P.