18F-FACBC compared with 11C-choline PET/CT in patients with biochemical relapse after radical prostatectomy: a prospective study in 28 patients

Clin Genitourin Cancer. 2014 Apr;12(2):106-10. doi: 10.1016/j.clgc.2013.08.002. Epub 2013 Oct 14.


Introduction: The aim of our study was to compare the detection rate of anti-3-18F-FACBC PET/CT in comparison with 11C-choline PET/CT in the evaluation of disease recurrence of PCa after radical prostatectomy.

Patients and methods: Twenty-eight consecutive patients with biochemical relapse after radical prostatectomy were submitted to anti-3-18F-FACBC PET/CT and 11C-choline PET/CT to evaluate the site of disease recurrence. Androgen deprivation therapy was avoided in all cases. The primary end point was the overall detection rate of the 2 radiotracers. A patient-based analysis and a lesion-based analysis was performed. The target to background ratio (TBR) of each lesion was reported.

Results: At the time of PET scan, mean age was 67 years and mean prostate specific antigen (PSA) relapse was 2.9 ng/mL (range: 0.2-14.6). In patient-based analyses, 11C-choline PET/CT was positive in 5 patients and negative in 23 (detection rate = 17.8%) and anti-3-18F-FACBC PET/CT was positive in 10 patients and negative in 18 (detection rate = 35.7%). All lesions that were positive using 11C-choline were positive using anti-3-18F-FACBC PET/CT but with the latter radiotracer, 11 (61.1%) additional tumors were identified including 5 (17.8%) additional patients. The TBR of anti-3-18F-FACBC was greater than 11C-choline in 15 of 18 lesions, confirming a better image quality and contrast.

Conclusion: This preliminary study demonstrated that the detection rate of anti-3-18F-FACBC PET/CT is greater in comparison with 11C-choline, with approximately 20% of additional patients and approximately 60% additional lesions detected. Further studies, however, are required to assess the exact added value of this new tracer.

Keywords: 11C-Choline PET/CT; Biochemical relapse; Bone metastasis; Lymph node metastases; Prostate cancer; Restaging.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Carbon Radioisotopes
  • Carboxylic Acids*
  • Choline*
  • Cyclobutanes*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / prevention & control
  • Positron-Emission Tomography
  • Prospective Studies
  • Prostatectomy
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / surgery
  • Radiopharmaceuticals*
  • Tomography, X-Ray Computed


  • Carbon Radioisotopes
  • Carboxylic Acids
  • Cyclobutanes
  • Radiopharmaceuticals
  • fluciclovine F-18
  • Choline