What is the role of PET scanning in the workup of prostate cancer?

Updated: Jan 15, 2019
  • Author: Lanna Cheuck, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

There is increasing interest in using metabolic activity to detect cancer foci. Positron emission tomography (PET) scanning uses glucose analogue 18 F-fluorodeoxyglucose (18 F-FDG) to detect cancer, but studies thus far have been disappointing for prostate cancer detection.

C-choline PET scanning fused with CT imaging shows more promise but is not yet the standard of care.

Fluciclovine F 18 (Axumin) was approved in May 2016 for PET imaging in men with suspected prostate cancer recurrence. Approval was based on a comparative trial with 11C-choline. Sensitivities for 11C-choline and fluciclovine F 18 were 32% vs 37%, specificities 40% vs 67%, accuracies 32% vs 38%, and positive predictive values (PPVs) 90% vs 97%. [26] A second trial observed the diagnostic performance of fluciclovine PET/CT in recurrent prostate cancer was superior to that of CT and fluciclovine PET/CT provided better delineation of prostatic from extraprostatic recurrence. [27]


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