Poster, Podium & Video Sessions
Presentation Authors: Oladunni Akin-Akintayo*, Funmilayo Tade, Pardeep Mittal, Courtney Moreno, Peter Nieh, Peter Rossi, Halkar Raghuveer, Baowei Fei, Mark Goodman, David Schuster, Atlanta, GA
Introduction: To compare the diagnostic performance of PET-CT using the synthetic amino acid radiotracer fluciclovine with multiparametric magnetic resonance imaging (mpMRI) in recurrent prostate cancer.
Methods: 24 patients with biochemical failure after non-prostatectomy definitive therapy underwent fluciclovine PET-CT and mpMRI (T2, DWI and DCE) within 29 days with blinded interpretation by expert readers. Reference standard was established via histology and clinical follow-up. Diagnostic performance was calculated for each of 2 readers for PET-CT (P1 and P2) and 2 other readers for MRI (M1 and M2). For the purpose of this analysis, equivocal interpretations were analyzed as negative.
Results: In the prostate, 22 patients underwent biopsy with 13 malignant and 9 benign (2 not biopsied). Accuracy for PET was 63.6% for both readers. Accuracy for mpMR was 45.5% and 40.9% for readers M1 and M2, respectively. Overall, fluciclovine PET had higher sensitivity for both readers while mpMR had higher specificity (Figure 1a).
17 patients met the reference standard for extraprostatic disease detection. 7 of these were confirmed by histology and 10 by clinical follow-up. Accuracy for PET was 88.24% for both readers. Accuracy for mpMR was 52.94% and 70.79% for readers M1 and M2, respectively. Overall, fluciclovine PET had higher sensitivity and specificity compared to mpMR (Figure 1b).
Inter-reader agreement for fluciclovine PET was 91.6% in the prostate and 87.5% for extraprostatic disease detection. For mpMRI, inter-reader agreement was 37.5% and 75% respectively for prostate and extraprostatic disease detection.
Conclusions: Although fluciclovine PET-CT had higher sensitivity in the prostate, MRI had higher specificity for disease detection. However for extraprostatic disease, fluciclovine had higher sensitivity and specificity. Inter-reader agreement was better with fluciclovine PET-CT compared with mpMR.
Source Of Funding: National Institutes of Health
Blue Earth Diagnostics Limited supplied fluciclovine cassettes for the study.
Emory University, Atlanta, Georgia
Name: Dr. Oladunni Akin-Akintayo, MD, MPH; Research Associate/ Post-Doctoral Fellow, Emory University Atlanta, Georgia.
As a researcher in the Division of Nuclear medicine and molecular imaging at Emory University, I am involved in evaluating the use of a novel PET-CT radiotracer anti-1-amino-3-[(18)F]fluorocyclobutane-1-carboxylic acid (anti-3-[(18)F]FACBC/ fluciclovine/ Axumin) in the detection of prostate cancer and other malignancies including brain, parathyroid and breast. We are not limiting the use of FACBC to just the diagnosis of malignancies but further using our findings to guide clinical investigations and therapy such as 3D-guided biopsy and planning of radiotherapy.
Friday, May 12
3:30 PM – 5:30 PM