11C-Acetate can act as a probe of tissue metabolism through entry into catabolic or anabolic metabolic pathways as mediated by acetyl-coenzyme A. The uptake of (11)C-acetate in prostate cancer was investigated to determine whether this tracer has potential in tumor identification.
Methods: Twenty-two patients with prostate cancer underwent PET after intravenous administration of 740 MBq (11)C-acetate. Eighteen of the 22 patients were also investigated with (18)F-FDG PET. Standardized uptake values (SUVs) for each tumor were investigated for tracer activity at 10-20 min after (11)C-acetate and 40-60 min after (18)F-FDG administration.
Results: Adenocarcinoma of the prostate showed variable uptake of (11)C-acetate, with SUVs ranging from 3.27 to 9.87. In contrast, SUVs for (18)F-FDG ranged from 1.97 to 6.34. By visual inspection, (11)C-acetate accumulation in primary prostate tumors was positive in all patients, whereas (18)F-FDG accumulation was positive in only 15 of 18 patients. (11)C-Acetate PET in a patient with lymph node metastasis showed high intrapelvic accumulation corresponding to metastatic sites. Similarly, 2 patients with bone metastases were (11)C-acetate avid.
Conclusion: (11)C-Acetate shows marked uptake in prostate cancer and is more sensitive in detection of prostate cancer than is (18)F-FDG PET. (11)C-Acetate represents a new tracer for detection of prostate cancer with PET, measuring radiopharmaceutical uptake pathways that are different from those measured by (18)F-FDG.