title: 18F-Fluciclovine PET/CT for the Detection of Prostate Cancer Relapse: A Comparison to 11C-Choline PET/CT.
abstract: OBJECTIVE
  In recent years, a new PET compound (anti-3-(18)F-FACBC or (18)F-fluciclovine) was tested for the detection of prostate cancer relapse. Despite very promising results, only preliminary data were available with regard to the comparison to (11)C-choline. The aim of this study was to compare the detection rate of (18)F-FACBC and (11)C-choline in patients presenting a biochemical relapse.
  
  
  METHODS
  Fifty patients radically treated for prostate cancer and presenting with rising prostate-specific antigen (PSA) levels were consecutively and prospectively enrolled. All the patients were out of hormonal therapy and underwent both (11)C-choline PET/CT and (18)F-fluciclovine PET/CT within 1 week. The results were compared in terms of detection rate on a patient and lesion basis. Furthermore, a more detailed analysis regarding local, lymph node, and bone relapse was performed.
  
  
  RESULTS
  On a patient-based analysis, (18)F-fluciclovine detection turned out to be significantly superior to (11)C-choline (P < 0.000001). This result was also true on lesion, lymph node, bone lesion, and local relapse analysis (P < 0.0001 in all the cases). There was no significant difference in terms of target to background of positive lesions between (11)C-choline and (18)F-fluciclovine. When the patients were divided into groups with different PSA levels, (18)F-fluciclovine had a superior detection rate for low, intermediate, and high PSA levels.
  
  
  CONCLUSIONS
  In our experimental conditions, (18)F-fluciclovine provided a statistically significant better performance in terms of lesion detection rate as compared with (11)C-choline. However, more studies are required to evaluate the clinical significance of these results in terms of sensitivity, specificity, and accuracy.
authors.affiliation: From the *OU Nuclear Medicine, †OU Urology, and ‡OU Medical Physics, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiavina
authors.forename: Eugenio
authors.initials: E
authors.lastname: Brunocilla
authors.forename: Stefano
authors.initials: S
authors.lastname: Boschi
authors.forename: Marco
authors.initials: M
authors.lastname: Borghesi
authors.forename: Lucia
authors.initials: L
authors.lastname: Zanoni
authors.forename: Cinzia
authors.initials: C
authors.lastname: Pettinato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martorana
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D000368:Aged; D002250:Carbon Radioisotopes; D002264:Carboxylic Acids; D002794:Choline; D003503:Cyclobutanes; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D002264:Carboxylic Acids; D003503:Cyclobutanes; D019275:Radiopharmaceuticals; C117460:fluciclovine F-18; D002794:Choline