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[11C]acetate is a radiopharmaceutical used as a metabolic tracer in positron emission tomography (PET) imaging. It consists of the acetate anion labeled with the positron-emitting radioisotope carbon-11. In the body, acetate is a substrate for the synthesis of fatty acids and cholesterol, a process that is significantly upregulated in certain malignancies, including prostate cancer and hepatocellular carcinoma. Upon intravenous administration, [11C]acetate is transported into cells and converted into acetyl-CoA by acetyl-CoA synthetase, which is then incorporated into the lipid bilayer of cell membranes via the fatty acid synthesis pathway. This metabolic trapping allows for the detection of cancerous tissues that exhibit low glucose avidity and are therefore difficult to image with standard [18F]FDG PET. The tracer is particularly utilized in the evaluation of biochemical recurrence in prostate cancer patients, helping to guide clinical management decisions by identifying local recurrence or metastatic disease.
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