Role of F-Fluciclovine and Prostate-Specific Membrane Antigen PET/CT in Guiding Oligometastatic Prostate Cancer Management: Expert Panel Narrative Review. Journal Article

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Authors: Savir-Baruch, B; Choyke, PL; Rowe, SP; Schuster, DM; Subramaniam, RM; Jadvar, H
Article Title: Role of F-Fluciclovine and Prostate-Specific Membrane Antigen PET/CT in Guiding Oligometastatic Prostate Cancer Management: Expert Panel Narrative Review.
Abstract: Oligometastatic disease was proposed 25 years ago as an intermediary clinical state in cancer with unique implications for therapies that may impact cancer evolution and patient outcome. Identification of limited metastases potentially amenable to targeted therapies fundamentally depends on the sensitivity of the diagnostic tools, including new-generation imaging methods. In men with biochemical recurrence after definitive therapy of the primary prostate cancer, PET using either the FDA-approved radiolabeled amino acid analog 18F-fluciclovine or the investigational radiolabeled agents targeting the prostate-specific membrane antigen (PSMA) enables identification of early metastases at serum PSA levels lower than previously feasible by conventional imaging. Of these, evidence supports PSMA PET/CT as the most sensitive imaging modality available for identifying disease sites in oligometastatic prostate cancer. PSMA PET/CT will likely become the modality of choice after regulatory approval and drive development of trials of emerging metastasis-directed therapies such as stereotactic ablative body radiation and radioguided surgery. Indeed, numerous ongoing or planned clinical trials are studying advances in management of oligometastatic prostate cancer based on this heightened diagnostic capacity. In this rapidly evolving clinical environment, radiologists and nuclear medicine physicians will play major roles in facilitating clinical decision making and management of patients with oligometastatic prostate cancer.
Journal Title: AJR. American journal of roentgenology
Publisher: Unknown  
Date Published: 2020