Table 4.
Positive 18F-Fluciclovine PET/CT
| No. | Initial PSA | GS | EPE | SVI | SM | T | N | M | Risk class. | Primary Rx | PSA after primary Rx | Subsequent Rx | PSA after subsequent Rx | Castration status | PSAPET | Detected lesions | Concordant work-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 5.1 | 7 (4+3) | yes | yes | no | T3b | N0 | M0 | high | Neoadjuvant ADT + RP + PLND | undetectable | Intermittent 1st-line ADT + Abiraterone | detectable | CRPC | 0.3* | Right prostatectomy bed, size 1.4×1.0 cm., SUVmax 3.6 | CT |
| 2 | 40 | 8 (4+4) | n/a | n/a | n/a | T2 | N0 | M0 | high | RT + 1st-line ADT for 2 years | undetectable | 1st-line ADT for 6 years | undetectable | CRPC | 0.4* | Left side of prostate bed, size n/a, SUVmax 4.3 | MRI |
| 3 | 5.8 | 6 (3+3) | no | no | yes | T2 | N0 | M0 | intermediate | RP + PLND | detectable | RT | undetectable | CSPC | 0.4 | Left prostatectomy bed, size n/a, SUVmax 4.0 | Biopsy |
| 4 | n/a | 8 (3+5) | yes | no | no | T3a | N0 | M0 | high | RP + PLND | undetectable | - CMT + 1st-line ADT | undetectable | CRPC | 0.2* | Two right external iliac LNs, size 0.9 cm., SUVmax 5.4 and size 0.6 cm., SUVmax 4.1 | CT |
| - Abiraterone | |||||||||||||||||
| - Cryoablation | |||||||||||||||||
| 5 | 1.4 | 8 (4+4) | yes | yes | no | T3b | N0 | M0 | very high | RP + PLND | detectable | RT + 1st-line ADT | undetectable | CSPC | 0.4 | Left pelvic LN | - |
| size 1.0 cm., SUVmax 11.4 | |||||||||||||||||
| Left deep inguinal LN | |||||||||||||||||
| size 0.7 cm., SUVmax 5.5 | |||||||||||||||||
| 6 | 3.4 | 9 (4+5) | yes | no | yes | T3a | N0 | M0 | high | RP + PLND | detectable | RT | undetectable | CSPC | 0.4 | Right external iliac LN | - |
| size 1.0 cm., SUVmax 6.0 | |||||||||||||||||
| Left internal iliac LN | |||||||||||||||||
| size 0.7 cm., SUVmax 6.0 | |||||||||||||||||
| 7 | 6.89 | 9 (4+5) | yes | yes | no | T3b | N1 | M0 | very high | RP + PLND | undetectable | 1st-line ADT for 1 year | undetectable | CSPC | 0.5 | Bone metastasis at both iliac bones, few thoracic vertebrae and few ribs | MRI |
*
PSA during ADT;
PSA, prostate-specific antigen; n/a, not available; GS, Gleason score; EPE, extra-prostatic extension; SVI, seminal vesicle invasion; SM, surgical margin; T, tumor classification; N, lymph node classification; M, metastasis; class, classification; Rx, treatment; RP, radical prostatectomy; PLND, pelvic lymph node dissection; RT, radiotherapy; 1st-line ADT, first-line androgen deprivation therapy; PSAPET, PSA level at time of 18F-Fluciclovine PET/CT; CSPC, castration-sensitive prostate cancer; CRPC, castration-resistant prostate cancer; SUV, standardized uptake value; LN, lymph node; CT, computerized tomography; MRI, magnetic-resonance imaging.