Fluciclovine PET/CT Skull Base to Mid-Thigh Although fluciclovine PET/CT is primarily used in the recurrent setting, it can also be considered in the pretreatment assessment of prostate cancer based on its ability to better detect nodal and distant metastases than CT and bone scan [98,102]. The specificity of fluciclovine PET/CT is high (0.98, 95% CI: 0.88-1.00) [98], and in a study of 57 patients, it demonstrated a higher sensitivity for detecting nodal metastases (55.3% versus 33.3%) and was able to identify 12.3% (7/57) additional patients with distant metastasis when compared with conventional imaging (bone scan and CT) in patients with intermediate- and high-risk disease [106]. Fluciclovine PET/MRI Skull Base to Mid-Thigh Fluciclovine PET/MRI is less commonly used than fluciclovine PET/CT but shares similar principles and can be considered in the pretreatment assessment of prostate cancer based on its ability to better detect nodal and distant metastases than CT and bone scan [102,105]. The specificity of fluciclovine PET/CT is high (0.98, 95% CI: 0.88- 1.00) [98], and in a study of 57 patients, it demonstrated a higher sensitivity for detecting nodal metastases (55.3% versus 33.3%) and was able to identify 12.3% (7/57) additional patients with distant metastasis when compared with conventional imaging (bone scan and CT) in patients with intermediate- and high-risk disease [106]. In a study of 28 patients with high-risk disease who underwent fluciclovine PET/MRI, the sensitivity and specificity for detecting nodal metastases was 40% and 100%, respectively [105]. Pretreatment Detection of Prostate Cancer MRI Abdomen and Pelvis Without and With IV Contrast The literature indicates MRI abdomen and pelvis may be used in high-risk patients for 1) nodal and distant metastasis staging in addition to 2) assessment of the local extent of primary tumor [109-112].
Pretreatment Detection Surveillance and Staging of Prostate Cancer. Fluciclovine PET/CT Skull Base to Mid-Thigh Although fluciclovine PET/CT is primarily used in the recurrent setting, it can also be considered in the pretreatment assessment of prostate cancer based on its ability to better detect nodal and distant metastases than CT and bone scan [98,102]. The specificity of fluciclovine PET/CT is high (0.98, 95% CI: 0.88-1.00) [98], and in a study of 57 patients, it demonstrated a higher sensitivity for detecting nodal metastases (55.3% versus 33.3%) and was able to identify 12.3% (7/57) additional patients with distant metastasis when compared with conventional imaging (bone scan and CT) in patients with intermediate- and high-risk disease [106]. Fluciclovine PET/MRI Skull Base to Mid-Thigh Fluciclovine PET/MRI is less commonly used than fluciclovine PET/CT but shares similar principles and can be considered in the pretreatment assessment of prostate cancer based on its ability to better detect nodal and distant metastases than CT and bone scan [102,105]. The specificity of fluciclovine PET/CT is high (0.98, 95% CI: 0.88- 1.00) [98], and in a study of 57 patients, it demonstrated a higher sensitivity for detecting nodal metastases (55.3% versus 33.3%) and was able to identify 12.3% (7/57) additional patients with distant metastasis when compared with conventional imaging (bone scan and CT) in patients with intermediate- and high-risk disease [106]. In a study of 28 patients with high-risk disease who underwent fluciclovine PET/MRI, the sensitivity and specificity for detecting nodal metastases was 40% and 100%, respectively [105]. Pretreatment Detection of Prostate Cancer MRI Abdomen and Pelvis Without and With IV Contrast The literature indicates MRI abdomen and pelvis may be used in high-risk patients for 1) nodal and distant metastasis staging in addition to 2) assessment of the local extent of primary tumor [109-112].