Prostate Forum spoke with Dr. Fabio Almeida of the Southwest PET/CT Institute about the Carbon-11 acetate PET/CT scan for prostate cancer. To read more about Dr. Almeida’s work on the Carbon-11 acetate PET/CT scan and prostate cancer, see Prostate Forum Volume 15 # 5.
We are quite far along with our experience with Carbon-11 acetate, with over 380 patients. The vast majority are patients with recurrent prostate cancer. In general, we’re finding this test to be a useful problem-solving tool, giving people specific context of where these recurrences might be and options for how to treat it. In general, with the modern technology (PET/CT), the equipment itself, the techniques we’re using for imaging, and the agent itself, we’re seeing better results than have been seen in Europe. Our experience with carbon acetate is also so far showing better results than carbon choline being done elsewhere in the US, particularly for low PSAs. It’s been exciting from the perspective of imaging studies in that it’s performing better than other imaging studies for prostate cancer. We have very high sensitivity and very high specificity so it is a valuable tool for trouble-shooting.
Is insurance coverage difficult to obtain?
Some of the private payers are paying for the studies. When we’re able to do that we do need a referral. That’s another reason we do ask for a referral when we can get it. Medicare is not yet reimbursing for the scan. As a clinical trial, they generally don’t work within that confine until it’s FDA-approved. It’s an unfortunate obstacle for patients of course, and so there are some costs for the patient associated with the study.
What can you tell us about your clinic, the Southwest PET/CT Institute?
We are an organization of imaging centers across Arizona and California—Tucson, Phoenix, Yuma, and Palm Springs. We also have a radiation oncology clinic in Yuma. I, my colleagues, and my clinical trial staff, circulate between the sites. Our Phoenix facility is unique in that onsite with our imaging clinic (the Arizona Molecular Imaging Center) we have a research cyclotron managed by Cardinal Health. This means we’re onsite where carbon acetate is produced, which is a necessity to be able to use it. It has a very short half-life and does not travel. It needs to be used onsite. This is a one-of-a-kind private facility in the nation. Here we have a very dedicated professional staff of radiochemists and physicists who operate the cyclotron and do all the chemistry to FDA guidelines.