Prostate Cancer Clinical Trial
Official title:
Clinical Management Decisions Based on [11C]Acetate Positron Emission Tomography Performed on Prostate Cancer Patients With Biochemical Recurrence
When evaluating prostate cancer patients for recurrent disease, computed tomography (CT), and
magnetic resonance imaging (MRI) are both highly sensitive methods for detecting lymph nodes,
but are not specific as to whether the lymph nodes are malignant or benign.
While positron emission tomography (PET) utilizing radioactive glucose (FDG) has
revolutionized staging, restaging, and monitoring response to therapy in many prevalent
cancers such as breast, colorectal, esophageal, head and neck, lung, lymphoma, and melanoma,
findings with prostate cancer have proven less sensitive because prostate cancer has a lower
avidity for glucose. A newer PET isotope, utilizing acetate that is incorporated into the
cell membrane of rapidly proliferating cells, has shown greater sensitivity than FDG in
detecting prostate cancer.
This study will assess the clinical effectiveness of utilizing [11C]Acetate PET scans in
identifying recurrent prostate cancer.
FDG-PET imaging uses a form of radioactive glucose (18-fluoro-deoxyglucose or FDG), which
allows the measurement of glucose metabolic rate of any tissue in the body. The most
prevalent tumors have a glucose avidity that is typically greater than 2.5 times the avidity
of benign tissue. Therefore, FDG-PET is able to discriminate between benign lymph nodes and
those containing metastases, and similarly between scar tissue and recurrence of tumor.
Unfortunately, prostate cancer is only minimally glucose avid, and therefore, FDG-PET is much
less effective in staging prostate cancer. The current FDA-approved imaging agent for
prostate cancer is a monoclonal antibody specific for prostate cancer cells, capromab
pendetide, labeled with a long-lived radionuclide [111]Indium that is used to image the
patient over a six day period. However, recent data show that another PET
radiopharmaceutical, [11C]Acetate (which has been FDA approved for years for cardiac
imaging), is avidly taken up by prostate metastasis and is more sensitive than either
[111]Indium capromab pendetide or FDG-PET.
This study will assess the clinical effectiveness of utilizing [11C]Acetate PET scans in
identifying recurrent prostate cancer and aim to find at what PSA levels it is most
effective.
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