title: 11C-acetate PET/CT in bladder urothelial carcinoma: intraindividual comparison with 11C-choline.
abstract: OBJECTIVE
  We present a first study of the use of 11C-acetate (ACET) positron emission tomography (PET)/computed tomography (CT) in bladder urothelial carcinoma (UC) and an intraindividual comparison with 11C-choline (CHOL) PET/CT.
  
  
  METHODS
  Fourteen patients with biopsy-proven UC (11 T2, 3 T1 refractory to treatment) were prospectively evaluated before radical cystectomy and excision of pelvic lymph nodes (LNs), with ACET and CHOL PET/CT scans performed within 1 week. Image acquisition started 5 minutes after intravenous injection of 12 to 14 mCi for both tracers. Standardized uptake values (SUVs) and tumor-to-background ratios (TBR) were calculated for all tumor and nodal findings and correlated with histopathology and follow-up.
  
  
  RESULTS
  ACET and CHOL were taken up in all UCs, involved LNs, and prostate pathology. SUVs were on average slightly, nonsignificantly higher for CHOL uptake (SUV) in UCs and significantly higher for ACET in LNs. TBR was nonsignificantly higher with CHOL for UC and significantly higher for LNs.
  
  
  CONCLUSIONS
  In this preliminary series, 11C-ACET and 11C-CHOL PET/CT showed equivalent results in the preoperative evaluation of UC. Both tracers have the potential to contribute to selecting patients who would benefit from combined treatment--neoadjuvant chemotherapy and surgery--by identifying pathologic LNs or from surgery only, thanks to their high negative predictive value for LN involvement.
authors.affiliation: Department of Nuclear Medicine and Medical Biophysics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Marina
authors.initials: M
authors.lastname: Orevi
authors.forename: Martine
authors.initials: M
authors.lastname: Klein
authors.forename: Eyal
authors.initials: E
authors.lastname: Mishani
authors.forename: Roland
authors.initials: R
authors.lastname: Chisin
authors.forename: Nanette
authors.initials: N
authors.lastname: Freedman
authors.forename: Ofer N
authors.initials: ON
authors.lastname: Gofrit
mesh_terms: D000085:Acetates / Q000138:chemical synthesis* / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D002250:Carbon Radioisotopes; D002794:Choline; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011467:Prostate / Q000000981:diagnostic imaging / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D019459:Urothelium
chemical_list: D000085:Acetates; D002250:Carbon Radioisotopes; D002794:Choline