DOI: 10.1007/s00259-017-3875-1Pages: 1-10

Prospective evaluation of 18F-FACBC PET/CT and PET/MRI versus multiparametric MRI in intermediate- to high-risk prostate cancer patients (FLUCIPRO trial)

1. University of Turku, Department of Diagnostic Radiology

2. University of Massachusetts Medical School – Baystate, Department of Radiology

3. Turku PET Centre

4. Turku University Hospital, Department of Oncology and Radiotherapy

5. Turku University Hospital, Department of Urology

6. Turku University Hospital, Department of Clinical Physiology and Nuclear Medicine

7. University of Turku, Department of Information Technology

8. Turku University Hospital, Medical Imaging Centre of Southwest Finland

9. University of Turku and Turku University Hospital, Department of Pathology

Correspondence to:
Ivan Jambor
Tel: +358 2 313 0149
Email: ivan.jambor@utu.fi

Close

Abstract

Purpose

The purpose of this study was to evaluate 18F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa).

Methods

Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq 18F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUVmax) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (VT). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455.

Results

In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p < 0.01) outperformed that of PET/CT while no differences were detected between PET/MRI and mpMRI. SUVmax and VT of Gleason score (GS) >3 + 4 tumors were significantly (p < 0.05) higher than those for GS 3 + 3 and benign hyperplasia. A total of 442 lymph nodes were evaluable for staging, and PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes.

Conclusions

Quantitative 18F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. 18F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI.

To access the full text, please Sign in

If you have institutional access, please click here

  • Accepted: Nov 3, 2017
  • Online: Nov 16, 2017

Article Tools

eanm
EJNMMI Ad