Journal article
Impact of F-18-fluciclovine PET/CT on salvage radiotherapy plans for men with recurrence of prostate cancer postradical prostatectomy
Nuclear medicine communications, Vol.43(2), pp.201-211
02/01/2022
DOI: 10.1097/MNM.0000000000001501
PMCID: PMC8754096
PMID: 34669678
Abstract
Objectives Imaging options to localize biochemical recurrence (BCR) of prostate cancer after radical prostatectomy (RP) are limited, especially at low prostate-specific antigen (PSA) levels. The FALCON study evaluated the impact of F-18-fluciclovine PET/CT on management plans for patients with BCR. Here, we evaluate salvage radiotherapy decisions in patients post-RP. Methods We conducted a subgroup analysis of post-RP patients enrolled in FALCON who had a prescan plan for salvage radiotherapy (+/- androgen-deprivation therapy). Patients' treatment plans post-F-18-fluciclovine PET/CT were compared with their prescan plans. Fisher exact test was used to determine the impact of PSA and Gleason sum on positivity and anatomical patterns of uptake. Results Sixty-five (63%) FALCON patients had undergone RP. Of these, 62 (median PSA, 0.32 ng/mL) had a prescan plan for salvage radiotherapy. Twenty-one (34%) had F-18-fluciclovine-avid lesions. Disease was confined to the prostate bed in 11 patients (52%) and to the pelvis in a further 5 (24%), while 5 (24%) had extrapelvic findings. Trends towards more disseminated disease with increasing PSA or Gleason sum were observed but did not reach statistical significance. Postscan, 25 (40%) patients had a management change; 17 (68%) were changed to the treatment modality (8 to systemic therapy, 8 to active surveillance, 1 other) and 8 (32%) were radiotherapy field modifications. Conclusions Incorporating F-18-fluciclovine PET/CT into treatment planning may help identify patients suitable for salvage radiotherapy, help augment planned radiotherapy to better target lesions and support the clinician to optimise patient management.
Details
- Title: Subtitle
- Impact of F-18-fluciclovine PET/CT on salvage radiotherapy plans for men with recurrence of prostate cancer postradical prostatectomy
- Creators
- Heather Payne - University College London Hospitals NHS Foundation TrustJamshed Bomanji - University College London Hospitals NHS Foundation TrustDavid Bottomley - St James's University HospitalAndrew F. Scarsbrook - St James's University HospitalEugene J. Teoh - Cambridge University Hospitals NHS Foundation TrustFALCON study group
- Contributors
- Asim Afaq (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- Nuclear medicine communications, Vol.43(2), pp.201-211
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/MNM.0000000000001501
- PMID
- 34669678
- PMCID
- PMC8754096
- ISSN
- 0143-3636
- eISSN
- 1473-5628
- Number of pages
- 11
- Grant note
- Blue Earth Diagnostics Ltd Innovate UK; UK Research & Innovation (UKRI)
- Language
- English
- Date published
- 02/01/2022
- Academic Unit
- Radiology
- Record Identifier
- 9984318793402771
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