Hautzel H, Müller-Mattheis V, Herzog H, Roden W, Coenen H H, Ackermann R, Müller-Gärtner H W, Krause B J
Nuklearmedizinische Klinik, Heinrich-Heine-Universität Düsseldorf.
Urologe A. 2002 Nov;41(6):569-76. doi: 10.1007/s00120-002-0244-9.
The exact staging of prostate cancer is mandatory to allow selection of the appropriate primary therapy. In addition, if the PSA level rises again it is extremely important to find the site(s) of local recurrence or metastatic spread as soon as possible. However, with the morphological and metabolic imaging techniques currently available it is often not possible to answer these questions with adequate sensitivity and specificity, since small metastases < or = 1 cm in diameter are likely to remain undetected by them. In the last few years new radioactive labelled tracers have been introduced for use in positron emission tomography (PET), and it is hoped that the shortcomings in the diagnostic procedures used for prostate carcinoma might be compensated by their use. Besides 11C- or 18F-labelled choline, [11C]Acetate is also attracting attention as a promising PET tracer. In this paper we review the various PET tracers available and evaluate the advantages and the drawbacks of [11C]Acetate in three case studies by comparing [11C]Acetate-PET with histology and with other imaging techniques. The use of [11C]Acetate appears to be feasible and helpful in the diagnosis of prostate carcinoma. However, its final value relative to other imaging techniques needs further investigation, with special reference to initial lymph node involvement, early localisation of recurrence and possible noninvasive differentiation between prostate cancer, prostatis and benign hyperplasia of the prostate.
前列腺癌的准确分期对于选择合适的初始治疗至关重要。此外，如果前列腺特异性抗原（PSA）水平再次升高，尽快找到局部复发或转移扩散的部位极其重要。然而，就目前可用的形态学和代谢成像技术而言，往往无法以足够的敏感性和特异性回答这些问题，因为直径小于或等于1厘米的小转移灶很可能无法被它们检测到。在过去几年中，已引入新的放射性标记示踪剂用于正电子发射断层扫描（PET），人们希望通过使用这些示踪剂来弥补前列腺癌诊断程序中的不足。除了11C或18F标记的胆碱外，[11C]醋酸盐作为一种有前景的PET示踪剂也备受关注。在本文中，我们回顾了各种可用的PET示踪剂，并通过将[11C]醋酸盐PET与组织学及其他成像技术进行比较，在三个病例研究中评估了[11C]醋酸盐的优缺点。[11C]醋酸盐的使用在前列腺癌诊断中似乎是可行且有帮助的。然而，相对于其他成像技术，其最终价值需要进一步研究，尤其要关注初始淋巴结受累情况、复发的早期定位以及前列腺癌、前列腺炎和前列腺良性增生之间可能的无创鉴别。
