31. Clinical Application of [C-11]acetate in Oncology

Background and Purpose: [F-18]FDG has long been used for detection of the malignant tumors and assessment of the metabolic activity of the tumors. However, there are several drawbacks of FDG including hyperglycemic effect, nonspecific uptake on inflammation, sink phenomenon due to high accumulation of FDG in urinary tract, and physiologic uptake of FDG in the bowels and muscles, which may cause false positive as well as false negative results. [C-11]acetate, as a metabolic substrate of β-oxidation, precursors of amino acid, fatty acid and sterol, has been proved useful in detecting various malignancies. The aim of this study is to assess the feasibility of clinical application of [C-11]acetate in oncology.

Methods: High quality whole body images could be obtained by using large dosage (20 mCi) of [C-11]acetate and modern PET scanner. In the recent years, [C-11]acetate PET studies have been performed in 513 patients with various malignancies.

Results: The results showed that [C-11]acetate is more accurate in detecting meningioma (accuracy 97%), glioma (91%), nasopharyngeal cancer (93%), lymphoma (85%), non-small cell cancer (81%), colon cancer (78%), renal cell cancer (80%), ovarian cancer (76%), than in detecting small cell cancer of lung, thyroid cancer, and pancreas cancer. The advantages of [C-11]acetate are less time consuming (whole procedure completed within 45 min after injection), no hyperglycemic effect and no sink phenomenon. The disadvantages are increased uptake in salivary glands, pancreas, and sometimes the bowels, which may cause either false positive or false negative results, and on-site-cyclotron dependent.

Conclusion: In summary, [C-11]acetate is clinically useful in detecting various malignant tumors clinically and may play a complementary role to FDG.