The prostate/prostate bed was the most common site identified as harboring recurrent disease by the 18F-fluciclovine PET/CT imaging followed by the pelvic lymph nodes (18%). Possible recurrence was also detected in bone (8.7%), retroperitoneal lymph nodes (7.7%), other lymph nodes (3.8%), and soft tissue/parenchyma (2.9%).
The major changes to the treatment plan included a change from salvage treatment to watchful waiting for 16 men, a change from salvage therapy to non-curative systemic therapy in 16 men, and recommendations for alternative changes to the treatment modality in 11 men. Of the remaining 23 patients whose treatment plan was revised, the change involved modification of the intended plan for radiotherapy/brachytherapy.
Overall, 53 (80%) of the revisions were based on a positive scan result whereas the scan was negative in 33 (87%) of the cases in which the treatment plan was not revised.
No new safety concerns emerged with use of 18F-fluciclovine in the study.
Dr. Bottomley received travel support from Blue Earth Diagnostics Ltd., the company that markets 18F-fluciclovine.