Digital PET/CT with 18F-FACBC in early castration-resistant prostate cancer: our preliminary results. (3rd July 2022)

• Record Type: Journal Article
• Authors: Filippi, Luca; Bagni, Oreste; Schillaci, Orazio
• Is Part Of: Expert review of medical devices. Volume 19:Number 7(2022)
• Page Start: 591
• Page End: 598
• Publication Date: 2022-07-03
• Subjects: PET/CT -- nuclear medicine -- digital PET/CT -- precision medicine -- oncology -- 18F-fluciclovine -- prostate cancer; Medical instruments and apparatus -- Periodicals; 610.28
• DOI: 10.1080/17434440.2022.2117612
• Languages: English
• ISSNs: 1743-4440

Abstract

ABSTRACT: Background: We assessed the role of digital PET/CT (dPET/CT) with 18 F-FACBC in patients affected by castration-resistant prostate cancer with PSA levels ≤ 3 ng/mL (early CRPC), no lesions detectable at cross-sectional imaging (CIM) and bone scan (BS). Methods: Clinical data of patients submitted to 18 F-FACBC dPET/CT were retrospectively reviewed. PET/CT results were analyzed: lesions' number, location, and, in case of positive lymph nodes, largest node's short axis (i.e. SA) were annotated. According to PET/CT's results, patients with 18 F-FACBC-avid lesions were further stratified into 1) unifocal; 2) oligometastatic (≤ 5 lesions); 3) disseminated (> 6 lesions). Results: Twenty-four patients were enrolled. 18 F-FACBC dPET/CT was positive in 21 out of 24 patients (87.5%). Thirteen patients (54.1%) showed recurrence in pelvic region, seven of whom with pelvic nodes' involvement, while eight cases (33.3%) presented 18 F-FACBC-avid metastases to extra-pelvic nodes or bone. Average SA of PET-positive nodes resulted in 8.9 ± 3 mm. Patients were categorized as unifocal in four cases (26.6%), oligometastatic in 10 subjects (66.6%) and disseminated in 1 case (0.6%). PET/CT impacted on clinical management in 14 cases (58.3%). Conclusions: 18 F-FACBC dPET/CT detected M1 status in 33.3% of early CRPC patients, significantly impacting on clinical management.