MP20-16 68 GA-PSMA-11 PET/CT VS 18 F-FLUCICLOVINE PET/CT: A CASE SERIES IN PROSTATE CANCER PATIENTS WITH BIOCHEMICAL RECURRENCE

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2018MP20-16 68GA-PSMA-11 PET/CT VS 18F-FLUCICLOVINE PET/CT: A CASE SERIES IN PROSTATE CANCER PATIENTS WITH BIOCHEMICAL RECURRENCE Fuad Elkhoury, Jeremie Calais, Johannes Czernin, Wolfgang Fendler, Ken Herrmann, Matthias Eiber, Francesco Ceci, Robert Reiter, and Leonard Marks Fuad ElkhouryFuad Elkhoury More articles by this author , Jeremie CalaisJeremie Calais More articles by this author , Johannes CzerninJohannes Czernin More articles by this author , Wolfgang FendlerWolfgang Fendler More articles by this author , Ken HerrmannKen Herrmann More articles by this author , Matthias EiberMatthias Eiber More articles by this author , Francesco CeciFrancesco Ceci More articles by this author , Robert ReiterRobert Reiter More articles by this author , and Leonard MarksLeonard Marks More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.686AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 68G-PSMA-11 (PSMA) and 18F-Fluciclovine are radiopharmaceuticals used in PET/CT scanning to detect biochemical recurrence (BCR) of prostate cancer (CaP). Fluciclovine was FDA-approved in 2016; PSMA is not approved, but has a reported sensitivity >80%. No direct comparison of these two imaging techniques has been reported. The present examples offer a comparison of the two tests in men with BCR of CaP. METHODS Subjects were 6 men (ages 63-78) with rising and elevated PSA levels following primary treatment for CaP. All had fluciclovine scan followed by a PSMA scan within 4 months. PSMA scan was part of a clinical trial (NCT02940262). Prior CaP treatments included: radical prostatectomy (RP) with salvage radiotherapy (XRT) and androgen deprivation (ADT) in 3 patients; RP, adjuvant XRT, and ADT in 1 patient; and primary XRT and ADT in 2 patients. All 6 men had conventional imaging tests that were inconclusive or negative (bone scan, CT). Fluciclovine scan was performed using the manufacturer guide and PSMA scan was performed using a research protocol (J.Urol.195:1436, 2016). RESULTS Median PSA value at time of Fluciclovine and PSMA was 10.6 ng/mL (IQR 0.5-11.8) and 10.9 ng/mL (IQR 0.6-12.2), respectively. Fluciclovine-avid sites were found in 1/6 patients (16.6%) and PSMA-avid sites in 4/6 patients (66.6%). 3 of 5 patients with negative Fluciclovine had positive PSMA scans (Figure). Lesions detected by PSMA missed by Fluciclovine included bone lesions, lymph nodes (external iliac, retroperitoneal, and perirectal), and lung nodules. One patient had positive findings for local recurrence on both scans but PSMA detected additional extra-pelvic lymph node involvement. Two patients had concordantly negative scans. CONCLUSIONS This case series suggests increased sensitivity of 68G-PSMA-11 compared to 18F-Fluciclovine PET/CT for detection of nodal and metastatic disease in men with BCR of CaP. Over-expression of PSMA on the surface of CaP cells, coupled with the binding-affinity of the ligand, may explain these results. Prospective trials comparing these two imaging modalities are warranted. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e259 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Fuad Elkhoury More articles by this author Jeremie Calais More articles by this author Johannes Czernin More articles by this author Wolfgang Fendler More articles by this author Ken Herrmann More articles by this author Matthias Eiber More articles by this author Francesco Ceci More articles by this author Robert Reiter More articles by this author Leonard Marks More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...