18F-Fluciclovine Positron Emission Tomography in Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis

Abstract

Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting. Methods: A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were “PET” or “positron emission tomography” or “positron emission tomography/computed tomography” or “PET/CT” or “positron emission tomography-computed tomography” or “PET-CT” and “Fluciclovine” or “FACBC” and “prostatic neoplasms” or “prostate cancer” or “prostate carcinoma”. Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible. Results: Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80–0.86), the specificity of 0.77 (95% CI: 0.74–0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39–0.73) and specificity of 0.99 (95% CI: 0.94–1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63–0.73), and specificity of 0.68 (95% CI: 0.60–0.75). Conclusion: This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.

18F-Fluciclovine versus PSMA PET Imaging in Primary Tumor Detection during Initial Staging of High-Risk Prostate Cancer: A Systematic Review and Meta-Analysis

“…Similar results for 18 F-fluciclovine were described in the literature for primary prostate cancer (47,48). For example, in meta-analysis by Bin et al, the pooled sensitivity, specificity, and DOR of 18 F-fluciclovine in prostate cancer were 88%, 73%, and 20, respectively (49).…”

Diagnostic Accuracy of PET with 18F-Fluciclovine ([18F]FACBC) in Detecting High-Grade Gliomas: A Systematic Review and Meta-Analysis

“…Table 4 shows the diagnostic accuracy data of PET/CT or PET/MRI with [ 18 F]FACBC in HGG patients for individual studies. Overall, the index test has highlighted an excellent diagnostic performance for identifying HGG in all studies included in our systematic review, in different clinical scenarios, such as at initial diagnosis and in case of suspected recurrence after therapy [21][22][23][24][25][26][27][28]. Furthermore, PET/CT or PET/MRI with [ 18 F]FACBC was very valuable for the identification of multifocal disease in HGG patients [18,22,24,26].…”

Non-conventional and Investigational PET Radiotracers for Breast Cancer: A Systematic Review

“…Because of these limitations, other [ 18 F]-labeled amino acids have been developed. Anti-1-amino-3-[ 18 F]-fluorocyclo-butane-1-carboxylic acid ([ 18 F]-fluciclovine or [ 18 F]F-FACBC) is a synthetic amino acid, a leucine analog, mainly used in patients with prostate cancer, particularly in cases of biochemical disease recurrence ( 42 – 44 ).…”