title: Performance characteristics and relationship of PSA value/kinetics on carbon-11 acetate PET/CT imaging in biochemical relapse of prostate cancer.
abstract: An elevated serum prostate-specific antigen (PSA) level alone cannot distinguish between local-regional recurrences and distant metastases after treatment with curative intent. With available salvage treatments, it has become important to localize the site of recurrence.11C-Acetate PET/CT was performed in patients with rising PSA, with statistical analysis of detection rates, sites/location of detection, PSA kinetics and comparison with other tracers (FDG and Choline). Correlation to biopsy, subsequent imaging and PSA response to focal treatment was also performed. 88% (637) of 72111C-Acetate PET/CT scans performed were positive. There was a statistically significant difference in PSA values between the positive and negative scans (P < 0.001 for mean difference) with the percentage of positive scans and PSA having a positive correlation. A PSA of 1.09 ng/mL was found to be an optimal cutoff. PSAdT was significantly correlated with a positive scan only when the PSA was < 1.0 ng/mL. For this subgroup, a PSAdT of < 3.8 months appeared significant (P < 0.05) as an optimal cutoff point.11C-Acetate PET/CT demonstrates a high detection rate for the site of recurrence/metastasis in biochemical relapsed prostate cancer (88% overall detection rate, PPV 90.8%). This analysis suggests an optimal PSA threshold of > 1.09 ng/mL or a PSAdT of < 3.8 months when the PSA is below 1.0 ng/mL as independent predictors of positive findings.
authors.affiliation: Phoenix Molecular Imaging Phoenix, AZ, USA.
authors.forename: Fabio D
authors.initials: FD
authors.lastname: Almeida
authors.affiliation: Phoenix Molecular Imaging Phoenix, AZ, USA.
authors.forename: Chi-Kwan
authors.initials: CK
authors.lastname: Yen
authors.affiliation: Prostate Oncology Specialists Marina Del Rey, CA, USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Scholz
authors.affiliation: Prostate Oncology Specialists Marina Del Rey, CA, USA.
authors.forename: Richard Y
authors.initials: RY
authors.lastname: Lam
authors.affiliation: Prostate Oncology Specialists Marina Del Rey, CA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Turner
authors.affiliation: 21st Century Oncology Scottsdale, AZ, USA.
authors.forename: Larry L
authors.initials: LL
authors.lastname: Bans
authors.affiliation: 21st Century Oncology Scottsdale, AZ, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Lipson
keywords: PSA recurrence; Prostate cancer; carbon-11 acetate; positron emission tomography