PT - JOURNAL ARTICLE AU - Esther Mena AU - Baris Turkbey AU - Haresh Mani AU - Stephen Adler AU - Vladimir A. Valera AU - Marcelino Bernardo AU - Vijay Shah AU - Thomas Pohida AU - Yolanda McKinney AU - Gideon Kwarteng AU - Dagane Daar AU - Maria L. Lindenberg AU - Philip Eclarinal AU - Revia Wade AU - W. Marston Linehan AU - Maria J. Merino AU - Peter A. Pinto AU - Peter L. Choyke AU - Karen A. Kurdziel TI - <sup>11</sup>C-Acetate PET/CT in Localized Prostate Cancer: A Study with MRI and Histopathologic Correlation AID - 10.2967/jnumed.111.096032 DP - 2012 Apr 01 TA - Journal of Nuclear Medicine PG - 538--545 VI - 53 IP - 4 4099 - http://jnm.snmjournals.org/content/53/4/538.short 4100 - http://jnm.snmjournals.org/content/53/4/538.full SO - J Nucl Med2012 Apr 01; 53 AB - This work characterizes the uptake of 11C-acetate in prostate cancer (PCa), benign prostate hyperplasia, and normal prostate tissue in comparison with multiparametric MRI, whole-mount histopathology, and clinical markers to evaluate the potential utility of 11C-acetate for delineating intraprostatic tumors in a population of patients with localized PCa. Methods: Thirty-nine men with presumed localized PCa underwent dynamic–static abdominal–pelvic 11C-acetate PET/CT for 30 min and 3-T multiparametric MRI before prostatectomy. PET/CT images were registered to MR images using pelvic bones for initial rotation–translation, followed by manual adjustments to account for prostate motion and deformation from the MRI endorectal coil. Whole-mount pathology specimens were sectioned using an MRI-based patient-specific mold resulting in improved registration between the MRI, PET, and pathology. 11C-acetate PET standardized uptake values were compared with multiparametric MRI and pathology. Results: 11C-acetate uptake was rapid but reversible, peaking at 3–5 min after injection and reaching a relative plateau at approximately 10 min. The average maximum standardized uptake value (10–12 min) of tumors was significantly higher than that of normal prostate tissue (4.4 ± 2.05 [range, 1.8–9.2] vs. 2.1 ± 0.94 [range, 0.7–3.4], respectively; P &lt; 0.001); however, it was not significantly different from that of benign prostatic hyperplasia (4.8 ± 2.01 [range, 1.8–8.8]). A sector-based comparison with histopathology, including all tumors greater than 0.5 cm, revealed a sensitivity and specificity of 61.6% and 80.0%, respectively, for 11C-acetate PET/CT and 82.3% and 95.1%, respectively, for MRI. The 11C-acetate accuracy was comparable to that of MRI when only tumors greater than 0.9 cm were considered. In a small cohort (n = 9), 11C-acetate uptake was independent of fatty acid synthase expression using immunohistochemistry. Conclusion: 11C-acetate PET/CT demonstrates higher uptake in tumor foci than in normal prostate tissue; however, 11C-acetate uptake in tumors is similar to that in benign prostate hyperplasia nodules. Although 11C-acetate PET/CT is not likely to have utility as an independent modality for evaluation of localized PCa, the high uptake in tumors may make it useful for monitoring focal therapy when tissue damage after therapy may limit anatomic imaging methods.