The results indicated that fluoride has a higher diagnostic accuracy compared to bone scan (0.97 versus 0.842), whereas the dianostic accuracy of fluoride was similar to that of whole body MRI for detecting bone lesions (0.97 versus 0.947) [141]. In addition to its use for detecting bone lesions in the setting of metastatic prostate cancer, quantitative features extracted from fluoride PET have been reported to be promising in treatment response evalaution and prognosis [141]. Although its higher sensitivity for detecting bone metastases, the actual clinical benefit of fluoride PET on patient outcomes is yet to be reported. Fluciclovine PET/CT Skull Base to Mid-Thigh Fluciclovine is FDA approved (May 2016) for imaging of prostate cancer patients with BCR, and its use in metastatic prostate cancer is not as commonly reported as in BCR naturally. There are in vitro studies and anecdotal experience suggesting the potential utility with CRPC [142-144]. In a recent study with 106 patients, fluciclovine PET/CT was compared with bone scan for detecting bone metastases. The sensitivity, specificity, positive predictive value, and negative predictive value for bone scan were 79%, 86%, 45%, and 96%, respectively, whereas corresponding performance metrics for fluciclovine PET/CT were 100%, 98%, 89%, and 100%, respectively [145]. Fluciclovine PET/MRI Skull Base to Mid-Thigh There is limited evidence to support the use of fluciclovine PET/MRI for follow-up of a patient treated by systemic therapy. A small study of patients with primary prostate cancer treated with ADT reported a decrease in radiotracer uptake in local and metastatic lesions on PET/MRI [146].
Post Treatment Follow up of Prostate Cancer. The results indicated that fluoride has a higher diagnostic accuracy compared to bone scan (0.97 versus 0.842), whereas the dianostic accuracy of fluoride was similar to that of whole body MRI for detecting bone lesions (0.97 versus 0.947) [141]. In addition to its use for detecting bone lesions in the setting of metastatic prostate cancer, quantitative features extracted from fluoride PET have been reported to be promising in treatment response evalaution and prognosis [141]. Although its higher sensitivity for detecting bone metastases, the actual clinical benefit of fluoride PET on patient outcomes is yet to be reported. Fluciclovine PET/CT Skull Base to Mid-Thigh Fluciclovine is FDA approved (May 2016) for imaging of prostate cancer patients with BCR, and its use in metastatic prostate cancer is not as commonly reported as in BCR naturally. There are in vitro studies and anecdotal experience suggesting the potential utility with CRPC [142-144]. In a recent study with 106 patients, fluciclovine PET/CT was compared with bone scan for detecting bone metastases. The sensitivity, specificity, positive predictive value, and negative predictive value for bone scan were 79%, 86%, 45%, and 96%, respectively, whereas corresponding performance metrics for fluciclovine PET/CT were 100%, 98%, 89%, and 100%, respectively [145]. Fluciclovine PET/MRI Skull Base to Mid-Thigh There is limited evidence to support the use of fluciclovine PET/MRI for follow-up of a patient treated by systemic therapy. A small study of patients with primary prostate cancer treated with ADT reported a decrease in radiotracer uptake in local and metastatic lesions on PET/MRI [146].