Prediction of Prostate Cancer Specific Survival - The Prognostic Value of 11C-Acetate PET/CT- Jens Sorensen
Jens Sorensen, MD presents on the topic of the prognostic value of 11C-Acetate PET/CT. 11C-Acetate PET/CT is strongly linked to the aggressiveness of prostate cancer (PCa) under experimental conditions. 11C-Acetate PET/CT is a potential noninvasive biomarker of malignant lipogenesis in PCa, but its prognostic value is not known. The objective of this study was to analyze 11C-acetate PET/CT image metrics in relation to survival to assess the prognostic value of 11C-Acetate PET/CT of biochemical relapse patients after prostatectomy.
All patients undergoing 11C-Acetate PET/CT in one university hospital from 2005 to 2011 due to PSA relapse after previous prostatectomy were retrospectively evaluated. Two groups of patients were compared: those who died from PCa and those who were censored. All previously reported findings of local recurrence, regional or distal lymph node metastases and bone metastases were counted and evaluated regarding 11C-Acetate uptake intensity (SUVmax) and tumur volume. Total tumur volume and total lipogenic activity (TLA, summed SUVmax × TV) were calculated. Survival analysis in the entire study population was followed by Cox proportional hazards ratio (HR) analysis.
In conclusion, a negative 11C-Acetate PET/CT in asymptomatic patients with PSA relapse after prostatectomy suggests an excellent five year survival. Also, signs of distal metastases or intense lipogenic activity even at a very low PSA level indicates poor survival. The combined measurements of PET tumor volumes and lipogenic activity holds incremental and independent prognostic information beyond clinical parameters and standard anatomical staging.
Jens Sorensen Professor, MD, DMSc, Uppsala University | UU Department of Surgical Sciences, Uppsala, Sweden
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