Review ArticleContinuing Education

Update on 18F-Fluciclovine PET for Prostate Cancer Imaging

Ephraim E. Parent and David M. Schuster
Journal of Nuclear Medicine May 2018, 59 (5) 733-739; DOI: https://doi.org/10.2967/jnumed.117.204032

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    A 66-y-old man with biochemical recurrence of prostate cancer (PSA level, 29.3 ng/mL). Sagittal 18F-fluciclovine PET/CT (A), CT (B), and PET (C) found single suggestive focus of uptake in prostate resection bed. Patient underwent external-beam radiation of lesion, with corresponding PSA nadir (0.27 ng/mL)

  • FIGURE 2.
    FIGURE 2.

    A 73-y-old man with biochemical recurrence of prostate cancer after prostatectomy and lymphadenectomy (PSA level, 1.02 ng/mL; doubling time, 4.5 mo). Transaxial 18F-fluciclovine PET (A) and PET/CT (B) found single 0.9-cm retrocaval lymph node with SUV higher than that of bone marrow. Surgical excision was positive for metastasis and subsequent PSA nadir (0.08 ng/mL)

  • FIGURE 3.
    FIGURE 3.

    A 50-y-old man with biochemical recurrence of prostate cancer after prostatectomy (PSA level, 3.2 ng/mL; doubling time, 1.4 mo). MRI of abdomen, initially interpreted as negative, and subsequent 18F-fluciclovine PET/CT found multiple osseous metastases. Shown are transaxial PET/CT (A) and CT (B) through subtle left iliac bone lytic lesion and transaxial PET/CT (C) and CT (D) through silent right acetabular lesion.

  • FIGURE 4.
    FIGURE 4.

    Schema of 18F-fluciclovine PET/CT acquisition adapted from Emory clinical protocol. Maximum-intensity-projection 18F-fluciclovine images show normal biodistribution. Pancreas uptake is relatively higher than liver uptake, consistent with ideal time of image acquisition after injection. PET bed-position times are after injection (p.i.).

  • FIGURE 5.
    FIGURE 5.

    A 60-y-old man with biochemical recurrence of prostate cancer after prostatectomy (PSA level, 16.4 ng/mL; doubling time, 6.4 mo). 18F-fluciclovine PET/CT found metastatic mediastinal (A) and pulmonary nodules (B) on transaxial PET/CT. Patient was started on hormonal therapy with subsequent resolution of lymphadenopathy and pulmonary nodules and undetectable PSA.

  • FIGURE 6.
    FIGURE 6.

    A 60-y-old man with biochemical recurrence of prostate cancer (PSA level, 6.2 ng/mL). 18F-fluciclovine PET/CT demonstrated uptake in right iliac bone (arrows; without CT correlate) and in prostate bed (not shown) on coronal PET (A) and CT (B). Biopsy of right iliac bone found benign sclerosis. Uptake was linear and ill-defined, atypical of prostate metastases.

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools
Bookmark this article

Jump to section

Keywords