News | Radiopharmaceuticals and Tracers | March 16, 2017

Fluciclovine PET/CT Improves Radiotherapy Targeting for Recurrent Prostate Cancer

New study finds PET/CT in treatment planning leads to significant differences in target volumes

PET/CT, recurrent prostate cancer, fluciclovine F-18, Emory University

CTVPOST (red) = CTVPRE (yellow) union CTVPET (pink). Also shown (upper right corner) are the PRE (square) vs POST (triangle) dose volume histograms for PTV1, PTV2, rectum, bladder, and penile bulb, showing minimal impact on target coverage or organs at risk dose with the modified targets. Image courtesy of Ashesh B. Jani, M.D., and David Schuster, M.D., Emory University.

March 16, 2017 — The featured clinical investigation article of the March 2017 issue of the Journal of Nuclear Medicine demonstrates that the positron emission tomography (PET) radiotracer fluciclovine (fluorine-18; F-18) can help guide and monitor targeted treatment for recurrent prostate cancer, allowing for individualized, targeted therapy.

"This is the first study of its kind demonstrating changes in post-surgery radiotherapy target design with advanced molecular imaging in recurrent prostate cancer, with no demonstrated increase in early radiotherapy side effects," explained Ashesh B. Jani, M.D., of the Winship Cancer Institute of Emory University, Atlanta.

According to the American Cancer Society, one in seven men will develop prostate cancer in his lifetime. In 2017, more than 161,000 new diagnoses of prostate cancer are expected in the U.S., and about 26,730 deaths from the disease are anticipated.

For the study, 96 patients were enrolled in a clinical trial of radiotherapy for recurrent prostate cancer after prostatectomy. All patients underwent initial treatment planning based on results from conventional abdominopelvic imaging with computed tomography (CT) or magnetic resonance imaging (MRI). Forty-five of the patients then underwent treatment-planning modification (better defining the tumor-targeted area) after additionally undergoing abdominopelvic F-18-fluciclovine PET/CT. No increase in toxicity was observed with this process.

The Emory researchers determined that the inclusion of F-18-fluciclovine PET information in the treatment planning process leads to significant differences in target volumes. It did result in higher radiation dose delivered to the penile bulb, but no significant differences in bladder or rectal radiation dose, or in acute genitourinary or gastrointestinal toxicity.

These are preliminary results in a three-year study, which hypothesizes that there will be an increase in disease-free survival for patients in the F-18-fluciclovine-modified treatment group over those in the standard treatment group.

This study could have implications beyond prostate cancer, Jani pointed out. "Our methodology is readily applicable to other novel imaging agents, and it may potentially facilitate improvement of cancer control outcomes," he said.

Authors of the article "Impact of Fluciclovine (18F) PET on Target Volume Definition for Post-Prostatectomy Salvage Radiotherapy: Initial Findings from a Randomized Trial" include Jani, Eduard Schreibmann, Peter J. Rossi, Joseph Shelton, Karen Godette, Peter Nieh, Viraj A. Master, Omer Kucuk, Mark Goodman, Raghuveer Halkar, Sherrie Cooper, Zhengjia Chen, and David M. Schuster, Emory University, Atlanta, Georgia.

This research was sponsored by the National Institutes of Health (R01 CA169188) and Blue Earth Diagnostics Ltd.

For more information: www.jnm.snmjournals.org

References

Jani, A.B., Schreibmann, E., Rossi, P.J., Shelton, J., et al. "Impact of Fluciclovine (18F) PET on Target Volume Definition for Post-Prostatectomy Salvage Radiotherapy: Initial Findings from a Randomized Trial," Journal of Nuclear Medicine. Published online Sept. 8, 2016. DOI: 10.2967/jnumed.116.176057

Related Content

Norwegian Study Confirms Benefits of Pressure-Based Breast Compression for Mammography
News | Mammography | May 22, 2017
Sigmascreening recently announced that a large independent Norwegian study further confirms Sigma’s hypothesis that...
Lantheus and GE Healthcare Sign Agreement for Worldwide Development, Commercialization of Flurpiridaz F-18
News | Radiopharmaceuticals and Tracers | May 22, 2017
May 22, 2017 — Lantheus Holdings Inc., parent company of Lantheus Medical Imaging Inc., and GE Healthcare announced t
ACR Select Extended to Cover Pediatric Imaging Indications and Exams
News | Clinical Decision Support | May 17, 2017
May 17, 2017 — Through the support of the American College of Radiology and the contribution of leading experts from
Seno Medical's Imagio Opto-Acoustic Breast Imaging System Proves Strong Predictor of Malignancy
News | Breast Imaging | May 16, 2017
Seno Medical Instruments Inc. recently announced that is Imagio opto-acoustic (OA/US) breast imaging system results...
Study Indicates Q-Collar May Help Protect Football Players' Brain Function
News | Neuro Imaging | May 15, 2017
A new study of high school football players adds to mounting evidence that the Q-Collar may help reduce brain injury...
FALCON Trial of Fluciclovine PET/CT Imaging Stops Recruitment after Successful Interim Analysis
News | Radiopharmaceuticals and Tracers | May 15, 2017
Blue Earth Diagnostics announced that the Trial Steering Committee recommended further recruitment be stopped in the...
Study Reveals Low Adoption of IAEA Recommendations for Reduced Nuclear Cardiology Radiation Exposure
News | Radiation Dose Management | May 12, 2017
A study in 65 countries has revealed low adoption of International Atomic Energy Agency (IAEA) recommendations to...
Arkansas Surgeon Reports Positive Findings From Use of BioZorb 3-D Marker
News | Radiation Therapy | May 12, 2017
A new research study concluded that use of the BioZorb surgical marker appears to provide better cosmetic outcomes and...
Large Nuclear Cardiology Laboratory Slashes Radiation Dose 60 Percent in Eight Years
News | Radiation Dose Management | May 11, 2017
A large nuclear cardiology laboratory in Missouri has slashed its average radiation dose by 60 percent in eight years,...
Overlay Init