18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial

Calais, Jérémie; Ceci, Francesco; Eiber, Matthias; Hope, Thomas A.; Hofman, Michael S; Rischpler, Christoph; Bach‐Gansmo, Tore; Nanni, Cristina; Savir-Baruch, Bital; Elashoff, David; Grogan, Tristan; Dahlbom, Magnus; Slavik, Roger; Gartmann, J; Nguyen, Kathleen; Lok, Vincent; Jadvar, Hossein; Kishan, Amar U.; Rettig, Matthew B.; Reiter, Robert E.; Fendler, Wolfgang P.; Czernin, Johannes

doi:10.1016/s1470-2045(19)30415-2

Cited by 352 publications

(211 citation statements)

References 27 publications

Supporting

Mentioning

201

Contrasting

Unclassified

Order By: Relevance

“…The results of the head to head Calais's trial, revealed that cancer detection rates of BCR per patient were significantly lower with fluciclovine PET than with PSMA-PET (26 vs. 56%; p = 0.0026). On further analysis, fluciclovine detection rates of BCR were significantly lower than PSMA-PET detection rates for the pelvic lymph node region (8 vs. 30%; p = 0.0034) and for any extrapelvic lesions (0 vs. 16%; p = 0.0078) (44).…”

Section: Is There Ln Involvement?mentioning

confidence: 75%

“…In a new a single-center study including 50 participants, Calais et al tested PSMA-PET and fluciclovine-PET head-to-head in the same patients and compared their cancer detection rates in patients with low serum PSA levels (<2 ng/ml) after radical prostatectomy. Detection rates for prostate bed recurrence did not differ significantly between the two radiotracers (18 vs. 14%; p = 0.73) (44).…”

Section: Is There Residual Tumor In the Prostate Bed?mentioning

confidence: 75%

“…Prospective data also shows clear superiority of PSMA-PET or fluciclovine-PET to choline-PET. Data from a new study suggests that PSMA-PET imaging is superior to fluciclovine-PET for detecting biochemical recurrence in men with prostate cancer (44). However, whether one of these radiotracers improves patient survival over the other is unknown and further research is needed to determine which has the greater effect.…”

Section: Summary Of the Main Findingsmentioning

confidence: 99%

See 2 more Smart Citations

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

et al. 2020

View full text Add to dashboard Cite

Background: Initial staging and assessment of treatment activity in metastatic prostate cancer (PCa) patients is controversial. Indications for the various available imaging modalities are not well-established due to rapid advancements in imaging and treatment. Methods:We conducted a critical literature review of the main imaging abnormalities that suggest a diagnosis of metastasis in localized and locally advanced PCa or in cases of biological relapse. We also assessed the role of the various imaging modalities available in routine clinical practice for the detection of metastases and response to treatment in metastatic PCa patients. Results:In published clinical trials, the most commonly used imaging modalities for the detection and evaluation of therapeutic response are bone scan, abdominopelvic computed tomography (CT), and pelvic and bone magnetic resonance imaging (MRI). For the detection and follow-up of metastases during treatment, modern imaging techniques i.e., choline-positron emission tomography (PET), fluciclovine-PET, or Prostate-specific membrane antigen (PSMA)-PET provide better sensitivity and specificity. This is particularly the case of fluciclovine-PET and PSMA-PET in cases of biochemical recurrence with low values of prostate specific antigen. Conclusions:In routine clinical practice, conventional imaging still have a role, and communication between imagers and clinicians should be encouraged. Present and future clinical trials should use modern imaging methods to clarify their usage. Inclusion and Exclusion CriteriaOnly original manuscripts and reviews published in indexed and peer-reviewed journals and written in English between August 1999 and December 2019 were considered. Cross-sectional studies, case reports, published abstracts, dissertation materials, and conference presentations were excluded. Of 1,725 potential articles from the literature search, 105 were selected, including 16 literature reviews, 5 meta-analyses, 11 guidelines or position papers, and 73 original articles.

show abstract

Section: Is There Ln Involvement?mentioning

confidence: 75%

Section: Is There Residual Tumor In the Prostate Bed?mentioning

confidence: 75%

Section: Summary Of the Main Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Various metabolic PET tracers reflecting glucose ( 18 F-FDG), fatty acid ( 11 C-acetate), phospholipid ( 11 C-, 18 F-choline) and amino acid ( 18 F-FACBC) pathways are available in PET practice for PCa diagnosis. PSMA-PET was previously shown to detect more lesions than 18 F-choline 37 , 11 C-choline 38 and 18 F-FACBC 39 . To the best of our knowledge, the current study is the first to compare PSMA-PET to acetate-PET.…”

Section: Discussionmentioning

confidence: 97%

Comparison of 68Ga-PSMA-11 PET/CT with 11C-acetate PET/CT in re-staging of prostate cancer relapse

Regula

Kostaras

Johansson

et al. 2020

Sci Rep

View full text Add to dashboard Cite

positron emission tomography (pet) imaging is used to localize recurrent disease in prostate cancer (pca). the tracer 68 Ga-PSMA-11 visualizes lesions overexpressing prostate-specific membrane antigen (pSMA), while 11 c-acetate visualizes lesions with increased anabolic metabolism. the aim of this study was to compare the performance of pSMA-pet and acetate-pet in re-staging patients with biochemical relapse. Thirty PCa patients with prostate-specific antigen (PSA) relapse after primary curative therapy were prospectively evaluated. PET/CT examinations using 11 c-acetate and 68 Ga-PSMA-11 were performed. Identified lesions were categorized according to anatomical location and pet measurements were correlated with pSA at time of scan. tumour lesions showed higher semiquantitative uptake values on PSMA-PET than acetate-PET. PSMA-PET identified more lesions in 11 patients, fewer lesions in eight patients, and identical number of lesions in 11 patients. This study indicates better diagnostic performance of PSMA-PET, particularly in detecting lymph node (81% vs 60%, p = 0.02) and bone metastasis (95% vs 61%, p = 0.0001) compared to acetate-PET. However, 38% of PSMA-expressing metastases appear to be metabolically inactive and 15% of metabolically active metastases lack PSMA expression. Addition of PET with a metabolic tracer, such as 11 c-acetate, might be beneficial before making treatment decisions.

show abstract

“…Prostate Cancer 1 week, and the reference standard was clinical follow-up at 1 year, including any available result(s) of additional imaging, PSA measurement, and pathological examination. Two published prospective paired-scan comparisons [31,32] of 18 F-fluciclovine PET/CT versus 68 Ga-PSMA-11 PET/CT showed mixed results. A University of California Los Angeles (UCLA) study involving 50 men with biochemical recurrence after radical prostatectomy and prescan PSA <2.0 ng/mL noted significantly lower detection rates with 18 F-fluciclovine overall (patient-level) and in the pelvic node and extrapelvic regions.…”

mentioning

confidence: 99%

Understanding and Improving ¹⁸F-Fluciclovine PET/CT Reports: A Guide for Physicians Treating Patients with Biochemical Recurrence of Prostate Cancer

Lowentritt¹,

Kipper

2020

Prostate Cancer

View full text Add to dashboard Cite

The positron emission tomography (PET) tracer 18F-fluciclovine has seen increasing use to localize disease in men with biochemical recurrence of prostate cancer, i.e., elevated prostate-specific antigen (PSA) levels post-treatment. 18F-Fluciclovine PET/computed tomography (CT) imaging reports now play central roles in many physician-patient discussions. However, because no standardized grading system or templates yet exist for 18F-fluciclovine image assessment, reports vary in format, comprehensiveness, and terminology and may be challenging to fully understand. To better utilize these documents, referring physicians should be aware of six key features of 18F-fluciclovine PET/CT. First, 18F-fluciclovine is a radiolabeled synthetic amino acid targeting the amino acid transporters ASCT2 and LAT1, which are ubiquitous throughout the body, but overexpressed in prostate cancer. Second, 18F-fluciclovine image interpretation is predominantly visual/qualitative: radiotracer uptake in suspicious lesions is compared with uptake in bone marrow or blood pool. Location of 18F-fluciclovine-avid lesions relative to typical recurrence sites and findings elsewhere in the patient are considered when evaluating lesions’ probability of malignancy, as is visibility on maximum intensity projection images when assessing bone lesions. Third, 18F-fluciclovine PET/CT detection rates increase as PSA levels rise. Fourth, detection rates may differ among centers, possibly due to equipment and reader experience. Fifth, since no diagnostic test is 100% accurate, scan data should not be used in isolation. Lastly, 18F-fluciclovine PET/CT findings frequently induce changes in disease management plans. In the prospective multicenter LOCATE and FALCON studies, scans altered management plans in 59% (126/213) and 64% (66/104) of patients, respectively; 78% (98/126) and 65% (43/66) of changes, respectively, involved modality switches. Referring physicians and imagers should collaborate to improve scan reports. Referrers should clearly convey critical information, including prescan PSA levels, and open clinical questions. Imagers should produce reports that read like consultations, avoid leaving open questions, and if needed, provide thoughts on next diagnostic steps.

show abstract

18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial

Cited by 352 publications

References 27 publications

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

Comparison of 68Ga-PSMA-11 PET/CT with 11C-acetate PET/CT in re-staging of prostate cancer relapse

Understanding and Improving ¹⁸F-Fluciclovine PET/CT Reports: A Guide for Physicians Treating Patients with Biochemical Recurrence of Prostate Cancer

Contact Info

Product

Resources

About

18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial

Cited by 352 publications

References 27 publications

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

Comparison of 68Ga-PSMA-11 PET/CT with 11C-acetate PET/CT in re-staging of prostate cancer relapse

Understanding and Improving 18F-Fluciclovine PET/CT Reports: A Guide for Physicians Treating Patients with Biochemical Recurrence of Prostate Cancer

Contact Info

Product

Resources

About

Understanding and Improving ¹⁸F-Fluciclovine PET/CT Reports: A Guide for Physicians Treating Patients with Biochemical Recurrence of Prostate Cancer