11C-Acetate PET/CT Non-FDG-Avid Tumors

Sponsor
Tel-Aviv Sourasky Medical Center (Other)
Overall Status
Unknown status
CT.gov ID
NCT00687778
Collaborator
(none)
100
1
25
4

Study Details

Study Description

Brief Summary

F18-FDG is the widely used PET tracer in the routine practice of oncologic disease imaging using the technology of PET-CT. However, FDG-avidity is a characteristic of the individual tumor. There are various types of human malignancies, which are not taking FDG in access. In these cases FDG is not a sensitive tracer of imaging. In search for other tumor PET tracers, C11-Acetate has been shown recently in a few early studies to have a potential value in imaging of non-FDG-avid tumors.

The purpose of the current study is to assess the role of 11C-acetate PET in various tumors, which often are not detected by 18F-FDG and were not widely assessed until now.

Detailed Description

Recent publications have suggested the use of 11C-acetate as another PET tracer for tumor imaging. The accumulation of 11C-acetate in tumor cells is related to the highly active lipid metabolism in the cell membrane associated with tumor growth. 11C-acetate is channeled into the tricarboxylic acid cycle via acetyl coenzyme A and then incorporated via phosphatidylcholine into the cell membrane's phopholipids. Possible biochemical paths of acetate incorporation or accumulation include (a) entering the Krebs cycle from acetyl coenzyme A (acetyl CoA) or as an intermediate metabolite, (b) esterification to form acetyl CoA as a major precursor in ß-oxidation for fatty acid synthesis, (c) combining with glycine in heme synthesis, and (d) through citrate for cholesterol synthesis. Of all of these possible metabolic pathways, participation in free fatty acid (lipid) synthesis is believed to be the dominant method of incorporation in tumors.

The clinical data on the role of 11C-acetate PET in human tumors is being accumulated. Most clinical studies have investigated the role of 11C-acetate PET in detection of prostate cancer. 11C-acetate PET was found valuable in the detection of recurrent prostate cancer, both in the prostate bed, lymph nodes and distant metastases. The main advantage of 11C-acetate is that it does not show physiological accumulation in the urinary bladder as is the case with 18F -FDG and therefore may be appropriate for the detection of active pelvic disease.

Comparing the uptake of 18F-FDG and of 11C-acetate in patients with lung carcinoma, the latter was found superior in the identification of a bronchiolo-alveolar carcinoma which often show no intense FDG uptake.

In the case of hepatic masses, well-differentiated HCC tumors were detect by 11C-acetate while poorly differentiated types were detected by 18F-FDG.

These data suggest that 11C-acetate PET may be valuable in the detection of well-differentiation slow growing tumors and may have a complementary role to the routinely used 18F-FDG.

Study Design

Study Type:
Observational
Anticipated Enrollment :
100 participants
Observational Model:
Cohort
Time Perspective:
Prospective
Study Start Date :
May 1, 2008
Anticipated Primary Completion Date :
Jun 1, 2009
Anticipated Study Completion Date :
Jun 1, 2010

Arms and Interventions

Arm Intervention/Treatment
1

100 patients with newly diagnosed tumors, which are often non-FDG avid or show only low intensity uptake: Soft tissue sarcomas, well-differentiated thyroid cancer, well-differentiated and bronchoalveolar lung cancer, indolent lymphomas, neuroendocrine tumors, GIST, uterine malignancies, mucin-producing cancer, teratoma, hepatoma, HCC and lobular breast carcinoma.

Outcome Measures

Primary Outcome Measures

  1. Uptake of C11-Acetate and F18-FDG in tumor will be measured in SUV PET units [At completion of acuisition]

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 90 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • patients with newly diagnosed tumors, which are often non-FDG avid or show only low intensity uptake:

  • Soft tissue sarcomas

  • well-differentiated thyroid cancer

  • well-differentiated and bronchoalveolar lung cancer

  • indolent lymphomas

  • neuroendocrine tumors

  • GIST

  • uterine malignancies

  • mucin-producing cancer

  • teratoma

  • hepatoma

  • HCC

  • lobular breast carcinoma

  • Patients over the age of 18

Exclusion Criteria:
  • patients under the age of 18 years

  • pregnant and lactating women

  • claustrophobic patients

Contacts and Locations

Locations

Site City State Country Postal Code
1 Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center Tel Aviv Israel 64239

Sponsors and Collaborators

  • Tel-Aviv Sourasky Medical Center

Investigators

  • Principal Investigator: Einat Even-Sapir, MD, PhD, Tel-Aviv Sourasky Medical Center

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
, ,
ClinicalTrials.gov Identifier:
NCT00687778
Other Study ID Numbers:
  • TASMC-08-EE-109-CTIL
First Posted:
Jun 2, 2008
Last Update Posted:
Jun 2, 2008
Last Verified:
May 1, 2008

Study Results

No Results Posted as of Jun 2, 2008