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. 2023 Nov 2;28(11):e1114-e1117.
doi: 10.1093/oncolo/oyad242.

A Pilot Study of F-18 Fluciclovine-PET/CT as a Diagnostic Tool for Bone Metastases in Patients With Castrate Resistant Prostate Adenocarcinoma and Correlative Analysis of Blood and Bone Molecular Testing (The FACT Study)

Hani M Babiker  1 , Matthew D Kay  2 , Carol Stuehm  2 , Gregory Woodhead  2 , Phillip H Kuo  3
Affiliations

A Pilot Study of F-18 Fluciclovine-PET/CT as a Diagnostic Tool for Bone Metastases in Patients With Castrate Resistant Prostate Adenocarcinoma and Correlative Analysis of Blood and Bone Molecular Testing (The FACT Study)

Hani M Babiker et al. Oncologist. .

Abstract

Background: Suspicious F-18 fluciclovine PET/CT findings for osseous metastases from prostate cancer (PC) were targeted for core needle biopsy. We correlated the maximum standardized uptake value (SUVmax) of biopsied lesions, with biopsy results, other diagnostic outcomes, and blood and tissue molecular analysis (TMA).

Material and methods: Patients with castrate resistant prostate cancer (CRPC) were recruited from a university oncology clinic. SUVmax, histology, blood, and TMA were correlated.

Results: Fifteen patients were enrolled and 12 underwent bone biopsies. Fifty percent of bone biopsies demonstrated malignancy. Higher SUVmax was associated with positive biopsies for adenocarcinoma (P = .003), and lesions with SUVmax ≥ 5.1 were all positive for malignancy. Significant correlation between blood and somatic TMA (P = .002) was also found.

Conclusion: Higher uptake of F-18 fluciclovine was associated with higher predictive value for osseous metastasis on biopsy. There was a significant correlation between blood and TMA.

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Conflict of interest statement

Hani Babiker (Last 12 months): Consultancy: Myovant, Corea Therapeutics, Novocure, Coherus BioSciences. Speakers Bureau: Guardant360. Research funds: Blue Earth, Novocure, Spirita Oncology. Tumor board: CARIS. Steering Committee/Medical Advisory Board: Novocure, Virogin Biotech, Idera, and JS InnoPharm. Matthew D. Kay is a consultant for Invicro and Blue Earth Diagnostics. Gregory Woodhead reported consulting/advisory relationships with Inari Consulting and ProKidney, and research funding from Penumbra. Phillip H. Kuo has been a consultant and/or speaker for Amgen, Bayer, Blue Earth Diagnostics, Chimerix, Eisai, Fusion Pharma, General Electric Healthcare, Invicro (also former employee), Novartis, Radionetics, Telix Pharmaceuticals, and UroToday. He is a recipient of research grants from Blue Earth Diagnostics and General Electric Healthcare. Carol Stuehm indicated no financial relationships.

Figures

Figure 1
Figure 1
F-18 fluciclovine PET with a biopsy-positive bone metastasis. (iA) Fused transaxial fluciclovine-PET/CT image demonstrates asymmetrically increased uptake in the left posterior iliac bone with SUVmax 6.8. Image is flipped to simulate prone position for easier comparison to biopsy position. (B) Transaxial image from CT performed for image-guided biopsy in prone position shows the successful placement of the needle. Pathology confirmed metastatic prostate adenocarcinoma. F-18 fluciclovine PET with a biopsy-negative bone metastasis. Fused transaxial fluciclovine-PET/CT image demonstrates a sclerotic lesion suspicious for metastasis in the right posterior iliac bone with SUVmax 1.6. Image is flipped to simulate prone position for easier comparison to biopsy position. (B) Transaxial image from CT performed for image-guided biopsy in prone position shows the successful placement of the needle. Pathology did not reveal any malignant cells.
Figure 1
Figure 1
F-18 fluciclovine PET with a biopsy-positive bone metastasis. (iA) Fused transaxial fluciclovine-PET/CT image demonstrates asymmetrically increased uptake in the left posterior iliac bone with SUVmax 6.8. Image is flipped to simulate prone position for easier comparison to biopsy position. (B) Transaxial image from CT performed for image-guided biopsy in prone position shows the successful placement of the needle. Pathology confirmed metastatic prostate adenocarcinoma. F-18 fluciclovine PET with a biopsy-negative bone metastasis. Fused transaxial fluciclovine-PET/CT image demonstrates a sclerotic lesion suspicious for metastasis in the right posterior iliac bone with SUVmax 1.6. Image is flipped to simulate prone position for easier comparison to biopsy position. (B) Transaxial image from CT performed for image-guided biopsy in prone position shows the successful placement of the needle. Pathology did not reveal any malignant cells.
See this image and copyright information in PMC

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