Trial reportEuropean journal of nuclear medicine and molecular imaging2026
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Trial report in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
purposeThe current EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines recommend radiolabeled prostate-specific membrane antigen (PSMA), choline, or fluciclovine PET/CT at biochemical recurrence (BCR) of prostate cancer (PCa) after radical prostatectomy. While studies compared [68Ga]Ga-PSMA-11 and [18F]Fluciclovine, data on 18F-labelled PSMA-ligands versus [18F]Fluciclovine in patients with low prostate-specific antigen (PSA) levels (< 2 ng/mL) are limited. This study compared the detection rates of [18F]Fluciclovine and [18F]DCFPyL PET/CT in patients with BCR after robot-assisted radical prostatectomy (RARP). Secondary objectives included stratifying detection rates by PSA level, anatomical regions and assessing inter-observer agreement.
methodsIn this prospective, single-center study, patients with BCR (PSA 0.2-2.0 ng/mL) underwent both [18F]Fluciclovine and [18F]DCFPyL PET/CT within 15 days. Three blinded nuclear medicine experts independently reviewed all scans. Lesions were classified as positive or negative in predefined regions (i.e., prostate bed, pelvic and extra-pelvic lymph nodes, bone, and visceral). Discrepancies were resolved by consensus, defined as majority agreement (≥ 2/3 readers). Inter-observer agreement was assessed using Fleiss’ kappa.
resultsOverall scan positivity was 44% (22/50 patients) for [18F]DCFPyL PET/CT and 24% (12/50) for [18F]Fluciclovine PET/CT (p = 0.018). Detection rates increased with rising PSA levels for both tracers. Local recurrence was detected by both tracers in 16% (8/50) of patients. Metastatic disease detection rates for [18F]DCFPyL versus [18F]Fluciclovine were 22% vs. 8.0% for pelvic lymph nodes (p = 0.016), and 6.0% versus 2.0% for distant metastases (p = 0.50), respectively. Inter-observer agreement was moderate for both tracers (κ = 0.59 for [18F]DCFPyL and κ = 0.55 for [18F]Fluciclovine).
conclusionThis study demonstrated the superiority of [18F]DCFPyL over [18F]Fluciclovine in detecting pelvic lymph node metastases in patients presenting with BCR after RARP at low PSA levels. These findings suggest the potential of [18F]DCFPyL PET/CT to facilitate earlier and more personalized salvage treatment strategies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.