Comparison of 18F-FACBC and 11C-choline PET/CT in patients with radically treated prostate cancer and biochemical relapse: preliminary results

Abstract

Our preliminary results indicate that anti-3-(18)F-FACBC may be superior to (11)C-choline for the identification of disease recurrence in the setting of biochemical failure. Further studies are required to assess efficacy of anti-3-(18)F-FACBC in a larger series of prostate cancer patients.

Molecular Imaging of Prostate Cancer with PET

“…However, 18 F-FDG uptake in tissue is not specific for cancer and benign conditions may also display high tracer localization. 18 F-FDG PET/CT is generally limited in the detection and initial staging of primary prostate cancer because many primary tumors are small, slow-growing, well-differentiated, and multiple with low-level tumor uptake that can overlap with that of normal tissue and coexisting benign prostatic hyperplasia. Poorly differentiated tumors and prostatitis both may demonstrate high uptake.…”

“…PET is a quantitative imaging tool for interrogation of the underlying tumor biology. Several promising radiotracers are currently being investigated for PET imaging evaluation of prostate cancer including, but not limited to, 18 F-FDG; 18 F-and 11 C-choline; 11 C-acetate; 16a-18 F-fluoro-5a -dihydrotestosterone, targeted to the androgen receptor; anti-1-amino-3-18 F-fluorocyclobutane-1-carboxylic acid, a synthetic L-leucine analog; and PET radiotracers based on prostate-specific membrane antigen (PSMA), prostate stem cell antigen, and gastrin-releasing peptide receptor (GRPR).…”

PSMA Ligands for PET Imaging of Prostate Cancer

“…Detection rates are positively associated with PSA level but are low (,50%) in patients with early BCR (i.e., PSA , 2 ng/mL) (11). Other PET radiopharmaceuticals have been investigated (e.g., 11 C-acetate) or even Food and Drug Administrationapproved (e.g., 18 F-fluciclovine), in part demonstrating superiority over choline derivatives (12)(13)(14)(15).…”

Prostate cancer imaging

“…In this issue, specific emphasis is placed on PET/CT with choline or acetate, whether 11 C-labelled or 18 F-labelled, as well as the investigational synthetic L-leucine analogue anti1-amino-3-18 F-fluorocyclobutane-1-carboxylic acid (anti-3-18 F-FACBC). While further studies are required to assess the efficacy of anti-3-18 F-FACBC in a larger series of prostate cancer patients, preliminary data reported by Nanni et al in this issue indicate a superiority of anti-3-18 F-FACBC over choline PET/CT in the detection of prostate cancer recurrence [9]. Although not covered in this issue, other novel investigational radiotracers such as radiolabelled prostate-specific membrane antigen [10] and bombesin analogues [11], may also have potential for clinical applications in prostate cancer.…”