A Pilot Study of F-18 Fluciclovine-PET/CT as a Diagnostic Tool for Bone Metastases in Patients With Castrate Resistant Prostate Adenocarcinoma and Correlative Analysis of Blood and Bone Molecular Testing (The FACT Study).

Suspicious F-18 fluciclovine PET/CT findings for osseous metastases from prostate cancer (PC) were targeted for core needle biopsy. We correlated the maximum standardized uptake value (SUVmax) of biopsied lesions, with biopsy results, other diagnostic outcomes, and blood and tissue molecular analysis (TMA).

Patients with castrate resistant prostate cancer (CRPC) were recruited from a university oncology clinic. SUVmax, histology, blood, and TMA were correlated.

Fifteen patients were enrolled and 12 underwent bone biopsies. Fifty percent of bone biopsies demonstrated malignancy. Higher SUVmax was associated with positive biopsies for adenocarcinoma (P = .003), and lesions with SUVmax ≥ 5.1 were all positive for malignancy. Significant correlation between blood and somatic TMA (P = .002) was also found.

Higher uptake of F-18 fluciclovine was associated with higher predictive value for osseous metastasis on biopsy. There was a significant correlation between blood and TMA.

The oncologist. 2023 Aug 24 [Epub ahead of print]

Hani M Babiker, Matthew D Kay, Carol Stuehm, Gregory Woodhead, Phillip H Kuo

Department of Medicine, Division of Hematology-Oncology, Mayo Clinic Cancer Center, Mayo Clinic Florida, Jacksonville, FL, USA., Department of Medical Imaging, University of Arizona, Tucson, AZ, USA., Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, AZ, USA.