Comparison of 68 Ga-PSMA-11 and 18 F-Fluciclovine PET/CT in a Case Series of 10 Patients with Prostate Cancer Recurrence

J Nucl Med. 2018 May;59(5):789-794. doi: 10.2967/jnumed.117.203257. Epub 2017 Dec 14.

Abstract

This was a head-to-head comparison between 68Ga-labeled prostate-specific membrane antigen (PSMA)-11 and 18F-fluciclovine PET/CT in a series of 10 patients with prostate cancer (PCa) recurrence. Methods: In total, 288 patients with PCa recurrence were enrolled in a prospective study of 68Ga-PSMA-11 PET/CT imaging for recurrent disease localization (ClinicalTrials.gov identifier NCT02940262). We retrospectively identified 10 patients who underwent clinically indicated 18F-fluciclovine PET/CT prior to enrollment. Results: The median time between the 2 scans was 2.2 mo (range, 0.2-4.2 mo). The median prostate-specific antigen (PSA) value was 1.0 ng/mL (mean, 4.7 ng/mL; range, 0.13-18.1 ng/mL) and 1.1 ng/mL (mean, 6.2 ng/mL; range, 0.24-31.3 ng/mL) at the time of 18F-fluciclovine and 68Ga-PSMA-11 PET/CT, respectively. Five of 10 patients (50%) were negative with 18F-fluciclovine but positive with 68Ga-PSMA-11 PET/CT. Two of 10 patients (20%) were positive with both 18F-fluciclovine and 68Ga-PSMA-11 PET/CT, but 68Ga-PSMA-11 PET/CT showed additional lymph nodes metastasis. Three of 10 patients (30%) were negative with both 18F-fluciclovine and 68Ga-PSMA-11 PET/CT. Conclusion: This case series suggests improved detection rates for 68Ga-PSMA-11 PET/CT when compared with 18F-fluciclovine PET/CT in patients with recurrent PCa. Prospective trials designed to directly compare the two should be initiated.

Keywords: PET/CT; PSMA; biochemical recurrence; fluciclovine; prostate cancer.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carboxylic Acids / chemistry*
  • Cyclobutanes / chemistry*
  • Edetic Acid / analogs & derivatives*
  • Edetic Acid / chemistry
  • Gallium / chemistry*
  • Gallium Isotopes
  • Gallium Radioisotopes
  • Humans
  • Ligands
  • Lymphatic Metastasis
  • Male
  • Neoplasm Recurrence, Local*
  • Oligopeptides / chemistry*
  • Positron Emission Tomography Computed Tomography*
  • Prospective Studies
  • Prostate-Specific Antigen / blood
  • Prostatectomy
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology
  • Radioisotopes / chemistry*

Substances

  • Carboxylic Acids
  • Cyclobutanes
  • Gallium Isotopes
  • Gallium Radioisotopes
  • Ligands
  • Oligopeptides
  • Radioisotopes
  • gallium 68 PSMA-11
  • fluciclovine F-18
  • Edetic Acid
  • Gallium
  • Prostate-Specific Antigen

Associated data

  • ClinicalTrials.gov/NCT02940262