[18F]fluciclovine vs. [18F]fluorocholine Positron Emission Tomography/Computed Tomography: A Head-to-Head Comparison for Early Detection of Biochemical Recurrence in Prostate Cancer Patients
| Title: | [18F]fluciclovine vs. [18F]fluorocholine Positron Emission Tomography/Computed Tomography: A Head-to-Head Comparison for Early Detection of Biochemical Recurrence in Prostate Cancer Patients |
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| Authors: | Cristina Ferrari, Paolo Mammucci, Valentina Lavelli, Antonio Rosario Pisani, Anna Giulia Nappi, Dino Rubini, Angela Sardaro, Giuseppe Rubini |
| Source: | Tomography, Vol 8, Iss 6, Pp 2709-2722 (2022) |
| Publisher Information: | MDPI AG, 2022. |
| Publication Year: | 2022 |
| Collection: | LCC:Computer applications to medicine. Medical informatics |
| Subject Terms: | prostate cancer, PET/CT, [18F]fluciclovine, [18F]fluorocholine, biochemical recurrence, PSA, Computer applications to medicine. Medical informatics, R858-859.7 |
| More Details: | Nowadays, there is still no consensus on the most accurate PET radiopharmaceutical to early detect prostate cancer (PCa) relapse. A tailored radiotracer choice based on a specific patient’s profile could ensure prompt disease detection and an improvement in patients management. We aimed to compare the [18F]fluciclovine and [18F]fluorocholine PET/CT detection rate (DR) in PCa patients restaged for early biochemical recurrence (BCR), according to clinical and biochemical features. A cohort of 138 PCa patients with early BCR (mean age: 71 y, range: 50–87 y) were homogeneously randomized 1:1 to a [18F]fluciclovine or a [18F]fluorocholine PET/CT group. The respective PET/CT DR, according to per-patient and per-region analysis, and the impact of the biochemical, clinical, and histological parameters, were compared. The PSA cut-off values predictive of a positive scan were also calculated. Overall, the [18F]fluciclovine PET/CT DR was 64%, significantly higher than the [18F]fluorocholine PET/CT DR of 35% (p = 0.001). Similarly, in the per-region analysis, the [18F]fluciclovine PET/CT DR was 51% in the prostate region, significantly higher compared to 15% of [18F]fluorocholine (p < 0.0001). Furthermore, a statistically significant higher DR in per-patient and per-region (prostate/prostate bed) analysis was observed in the [18F]fluciclovine group for 0.5–1 ng/mL (p = 0.018, p = 0.049) and >1 ng/mL (p = 0.040, p < 0.0001) PSA values. A PSA of 0.45 ng/mL for [18F]fluciclovine and of 0.94 ng/mL for [18F]fluorocholine was identified as the optimal cut-off value in predicting a positive PET/CT scan. Our results demonstrated a better [18F]fluciclovine PET/CT DR compared to [18F]fluorocholine for restaging PCa patients in early BCR, particularly in the detection of locoregional recurrence. The significantly higher [18F]fluciclovine DR for low PSA values (PSA < 1 ng/mL) supports its use in this setting of patients. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2379-139X 2379-1381 07403534 |
| Relation: | https://www.mdpi.com/2379-139X/8/6/226; https://doaj.org/toc/2379-1381; https://doaj.org/toc/2379-139X |
| DOI: | 10.3390/tomography8060226 |
| Access URL: | https://doaj.org/article/6e07403534b44035b43a8ee533e29437 |
| Accession Number: | edsdoj.6e07403534b44035b43a8ee533e29437 |
| Database: | Directory of Open Access Journals |
| ISSN: | 2379139X 23791381 07403534 |
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| DOI: | 10.3390/tomography8060226 |
| Published in: | Tomography |
| Language: | English |