Baowei Fei1,2,3, Olayinka A Abiodun-Ojo1, Akinyemi A Akintayo1, Oladunni Akin-Akintayo1, Funmilayo Tade4, Peter T Nieh5, Viraj A Master5, Mehrdad Alemozaffar5, Adeboye O Osunkoya5,6, Mark M Goodman1, David M Schuster1. 1. Department of Radiology and Imaging Sciences, Emory University School of Medicine , Atlanta , Georgia. 2. Department of Bioengineering, Erick Josson School of Engineering and Computer Science, University of Texas at Dallas , Richardson , Texas. 3. Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center , Dallas , Texas. 4. Department of Radiology, Loyola University , Chicago , Illinois. 5. Department of Urology, Emory University School of Medicine , Atlanta , Georgia. 6. Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta , Georgia.
Abstract
PURPOSE: We assessed the feasibility and cancer detection rate of fluciclovine (18F) positron emission tomography-ultrasound fusion targeted biopsy vs standard template biopsy in the same patient with biochemical failure after nonsurgical therapy for prostate cancer. MATERIALS AND METHODS: A total of 21 patients with a mean ± SD prostate specific antigen of 7.4 ± 6.8 ng/ml and biochemical failure after nonoperative prostate cancer treatment underwent fluciclovine (18F) positron emission tomography-computerized tomography (mean 364.1 ± 37.7 MBq) and planning transrectal prostate ultrasound with 3-dimensional image reconstruction. Focal prostatic activity on positron emission tomography was delineated and co-registered with planning ultrasound. During the subsequent biopsy session computer generated 12-core template biopsies were performed and then fluciclovine defined targets were revealed and biopsied. Histological analysis of template and targeted cores were completed. RESULTS: Template biopsy was positive for malignancy in 6 of 21 patients (28.6%), including 10 of 124 regions and 11 of 246 cores, vs targeted biopsy in 10 of 21 (47.6%), including 17 of 50 regions and 40 of 125 cores. Five of 21 patients had positive findings on targeted biopsy only and 1 of 21 had positive findings on template biopsy only. An additional case was upgraded from Grade Group 2 to 3 on targeted biopsy. Extraprostatic disease was detected in 8 of 21 men (38.1%) with histological confirmation in all 3 who underwent lesion biopsy. CONCLUSIONS: Fluciclovine positron emission tomography real-time ultrasound fusion guidance for biopsy is feasible in patients with biochemical failure after nonsurgical therapy for prostate cancer. It identifies more recurrent prostate cancer using fewer cores compared with template biopsy in the same patient. Further study is required to determine in what manner targeted biopsy may augment template biopsy of recurrent prostate cancer.
PURPOSE: We assessed the feasibility and cancer detection rate of fluciclovine (18F) positron emission tomography-ultrasound fusion targeted biopsy vs standard template biopsy in the same patient with biochemical failure after nonsurgical therapy for prostate cancer. MATERIALS AND METHODS: A total of 21 patients with a mean ± SD prostate specific antigen of 7.4 ± 6.8 ng/ml and biochemical failure after nonoperative prostate cancer treatment underwent fluciclovine (18F) positron emission tomography-computerized tomography (mean 364.1 ± 37.7 MBq) and planning transrectal prostate ultrasound with 3-dimensional image reconstruction. Focal prostatic activity on positron emission tomography was delineated and co-registered with planning ultrasound. During the subsequent biopsy session computer generated 12-core template biopsies were performed and then fluciclovine defined targets were revealed and biopsied. Histological analysis of template and targeted cores were completed. RESULTS: Template biopsy was positive for malignancy in 6 of 21 patients (28.6%), including 10 of 124 regions and 11 of 246 cores, vs targeted biopsy in 10 of 21 (47.6%), including 17 of 50 regions and 40 of 125 cores. Five of 21 patients had positive findings on targeted biopsy only and 1 of 21 had positive findings on template biopsy only. An additional case was upgraded from Grade Group 2 to 3 on targeted biopsy. Extraprostatic disease was detected in 8 of 21 men (38.1%) with histological confirmation in all 3 who underwent lesion biopsy. CONCLUSIONS:Fluciclovine positron emission tomography real-time ultrasound fusion guidance for biopsy is feasible in patients with biochemical failure after nonsurgical therapy for prostate cancer. It identifies more recurrent prostate cancer using fewer cores compared with template biopsy in the same patient. Further study is required to determine in what manner targeted biopsy may augment template biopsy of recurrent prostate cancer.
Authors: Kazuhiro Kitajima; Robert C Murphy; Mark A Nathan; Adam T Froemming; Clinton E Hagen; Naoki Takahashi; Akira Kawashima Journal: J Nucl Med Date: 2014-01-16 Impact factor: 10.057
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Authors: Olayinka A Abiodun-Ojo; Akinyemi A Akintayo; Oladunni O Akin-Akintayo; Funmilayo I Tade; Peter T Nieh; Viraj A Master; Mehrdad Alemozaffar; Adeboye O Osunkoya; Mark M Goodman; Baowei Fei; David M Schuster Journal: J Nucl Med Date: 2019-04-06 Impact factor: 10.057
Authors: Samuel J Galgano; Andrew M McDonald; Soroush Rais-Bahrami; Kristin K Porter; Gagandeep Choudhary; Constantine Burgan; Pradeep Bhambhvani; Jeffrey W Nix; Desiree E Morgan; Yufeng Li; John V Thomas; Jonathan McConathy Journal: AJR Am J Roentgenol Date: 2020-10-14 Impact factor: 6.582