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

Artificial Intelligence Used in Clinical Practice to Measure Breast Density
News | Artificial Intelligence | January 15, 2019
An artificial intelligence (AI) algorithm measures breast density at the level of an experienced mammographer,...
Machine Learning Uncovers New Insights Into Human Brain Through fMRI
News | Neuro Imaging | January 11, 2019
An interdisciplinary research team led by scientists from the National University of Singapore (NUS) has successfully...
Mobile App Data Collection Shows Promise for Population Health Surveys
News | Population Health | January 10, 2019
Mobile app data collection can bring access to more potential clinical study participants, reduce clinical study...
Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk
News | Magnetic Resonance Imaging (MRI) | January 08, 2019
Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the Qure.ai tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
Electronic Brachytherapy Effective in Long-Term Study of 1,000 Early-Stage Breast Cancers
News | Brachytherapy Systems, Women's Healthcare | January 07, 2019
Breast cancer recurrence rates of patients treated with intraoperative radiation therapy (IORT) using the Xoft Axxent...
Brachytherapy Alone Superior Treatment for Intermediate-Risk Prostate Cancer
News | Brachytherapy Systems | January 04, 2019
Patient-reported outcomes (PROs) indicated a significantly different clinician and patient-reported late toxicity...
Breast Cancer Patients Have Less Heart Damage With Heart Drug and Trastuzumab
News | Cardio-oncology | January 03, 2019
Breast cancer patients who take a heart drug at the same time as trastuzumab have less heart damage, according to a...
MRI Effective for Monitoring Liver Fat in Obese Patients
News | Magnetic Resonance Imaging (MRI) | December 28, 2018
Magnetic resonance imaging (MRI) provides a safe, noninvasive way to monitor liver fat levels in people who undergo...
Heart Attack, Stroke Risks Increase Leading Up to Cancer Diagnosis
News | Cardio-oncology | December 21, 2018
Older adults with cancer are more likely to have had a heart attack or stroke in the months prior to their cancer...