Poorly Differentiated Neuroendocrine Tumor With 18F-Fluciclovine Uptake in a Patient With Metastatic Castrate-Resistant Prostate Cancer

Abiodun-Ojo, Olayinka; Akintayo, Akinyemi A.; Harik, Lara; Bilen, Mehmet Asım; Halkar, Raghuveer

doi:10.1097/rlu.0000000000003408

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…ASCT2 was less expressed in mCRPC. To date there are case reports of 18F-fluciclovine PET positivity in neuroendocrine tumors, both dedifferentiated prostate cancer and secondary malignancies [35][36][37]. Small cell/neuroendocrine prostate cancer, however, can lose 18F-fluciclovine positivity likely due to becoming more poorly differentiated [38].…”

Section: Discussionmentioning

confidence: 99%

Evaluating appropriateness of 18F-fluciclovine PET/CT relative to standard of care imaging guidelines and the impact of ADT on positivity: a prospective study in 62 Veterans Administration patients at a single institution

Green,

Temsah,

Goldfarb

et al. 2024

Nuclear Medicine Communications

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Background According to the National Comprehensive Cancer Network Guidelines, 18F-fluciclovine PET/CT is considered appropriate after negative standard of care (SOC) imaging. Objective To prospectively compare 18F-fluciclovine to SOC imaging, investigate whether it should be done when SOC imaging is (+), and evaluate its detection rate in patients receiving androgen deprivation therapy. Methods We recruited 57 prostate cancer patients with biochemical recurrence with 18F-fluciclovine PET/CT and SOC imaging within 30 days. Prostate-specific antigen (PSA) level, Gleason score (GS), history of radical prostatectomy (RP), radiation therapy (RT) or hormone therapy (HT) were reviewed. Results The 57 patients had a median PSA of 2.6 and average GS of 7.4; 27 (47.4%) had RP, 28 (49.1%) had RT, 1 (1.75%) had HT and 1 (1.75%) observation only. 18F-fluciclovine identified disease recurrence in 45/57 patients (78.9%), including oligometastasis in 18/45 (40%). SOC imaging identified recurrent disease in 12/57 patients (21.1%) while 18F-fluciclvoine identified additional sites of disease in 11/12 (91.7%). The (+) 18F-fluciclovine studies had a median PSA 2.6 ng/ml compared to 6.0 ng/ml in the (+) SOC studies. Conclusion 18F-fluciclovine was superior to SOC imaging for lesion detection, identification of oligometastasis and identification of additional sites of disease.

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Section: Discussionmentioning

confidence: 99%

Evaluating appropriateness of 18F-fluciclovine PET/CT relative to standard of care imaging guidelines and the impact of ADT on positivity: a prospective study in 62 Veterans Administration patients at a single institution

Green,

Temsah,

Goldfarb

et al. 2024

Nuclear Medicine Communications

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“…Mixed neuroendocrine adenocarcinoma–acinar adenocarcinoma is an uncommon type of neuroendocrine prostate cancer, 1 representing <2% of all prostate malignancies at diagnosis 2 . Considering the possibility of a heterogeneous loss of PSMA expression in neuroendocrine prostate cancer, 3–5 68 Ga-FAPI and 18 F-FDG may be complementary to PSMA PET/CT in tumor staging 6–8 . In addition, the multitracer strategy may allow noninvasive characterization of intermetastatic heterogeneity in neuroendocrine prostate cancer.…”

mentioning

confidence: 99%

Visualization of Intermetastatic Heterogeneity in Mixed Neuroendocrine Carcinoma–Acinar Adenocarcinoma of the Prostate by 68Ga-PSMA, 68Ga-FAPI, and 18F-FDG PET/CT

Cai

Meng

et al. 2023

Clin Nucl Med

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Mixed neuroendocrine carcinoma-acinar carcinoma is an uncommon histological type of neuroendocrine prostate cancer. It has been rarely reported in de novo prostate malignancies. In this case, we present 68 Ga-PSMA (prostate-specific membrane antigen), 68 Ga-FAPI, and 18 F-FDG PET/CT findings in the de novo form of mixed large-cell neuroendocrine carcinoma-acinar adenocarcinoma of the prostate. Different levels of radiotracer uptake were observed in different metastatic sites on 68 Ga-PSMA, 68 Ga-FAPI, and 18 F-FDG PET/CT. This case demonstrates that the multitracer PET/CT strategy may be used for the noninvasive detection of the intermetastatic heterogeneity in metastatic neuroendocrine prostate cancer.

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Case 84: Metastatic Prostate Cancer or Neuroendocrine Tumor?

Wong

2022

Phenotypic Oncology PET

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Poorly Differentiated Neuroendocrine Tumor With 18F-Fluciclovine Uptake in a Patient With Metastatic Castrate-Resistant Prostate Cancer

Cited by 4 publications

References 16 publications

Evaluating appropriateness of 18F-fluciclovine PET/CT relative to standard of care imaging guidelines and the impact of ADT on positivity: a prospective study in 62 Veterans Administration patients at a single institution

Evaluating appropriateness of 18F-fluciclovine PET/CT relative to standard of care imaging guidelines and the impact of ADT on positivity: a prospective study in 62 Veterans Administration patients at a single institution

Visualization of Intermetastatic Heterogeneity in Mixed Neuroendocrine Carcinoma–Acinar Adenocarcinoma of the Prostate by 68Ga-PSMA, 68Ga-FAPI, and 18F-FDG PET/CT

Case 84: Metastatic Prostate Cancer or Neuroendocrine Tumor?

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