@article{Abiodun-Ojo01052018,
author = {Abiodun-Ojo, Olayinka and Fei, Baowei and Nieh, Peter and Master, Viraj and Akintayo, Akinyemi and Tade, Funmilayo and Akin-Akintayo, Oladunni and Alemozaffar, Mehrdad and OSUNKOYA, ADEBOYE and Goodman, Mark and Schuster, David}, 
title = {The role of fluciclovine (18F) PET/CT directed, 3D ultrasound-guided fusion targeted biopsy in the detection of biochemically recurrent prostate cancer},
volume = {59}, 
number = {supplement 1}, 
pages = {1481}, 
year = {2018}, 
abstract ={1481Objectives:   Amino acid transport is upregulated in prostate cancer. The aim of this study is to assess the role of the synthetic amino acid PET radiotracer fluciclovine (18F) in 3D ultrasound fusion image-guided biopsies for the detection of recurrence in patients with biochemical failure following non-surgical prostate cancer treatment. 
Methods:  Twenty-one patients (mean PSA 7.4±6.8) with biochemical failure (nadir PSA+2) after non-surgical prostate cancer treatment underwent sequential template and targeted biopsy in a single session. Regions of focal activity in the treated prostate over background on fluciclovine (18F) PET-CT (364.1±37.7 MBq) were delineated and then co-registered with a previously obtained planning 3-D ultrasound on an advanced work station. During the subsequent biopsy session, computer-generated template biopsies were first completed (typically 12), and then fluciclovine defined targets were revealed and biopsied. Histopathologic assessment of the template biopsy tissues were compared to those of the targeted biopsy. Based on tissue adequacy, Gleason scores (Grade groups) were reported in all cores with prostate cancer that did not demonstrate therapy related changes (19/29 malignant cores).

Results:   Template biopsy identified 6/21 (28.6%) patients with prostate cancer (11/246 cores) while targeted biopsy identified 10/21 (47.6%) patients with prostate cancer (18/52 cores). Five out of the six patients with template positive biopsies also had positive lesions on targeted biopsy. Three patients with both positive template and targeted biopsies had Gleason scores (Grade groups) reported, which resulted in an upgrade from Gleason score 3+4=7 (Grade group 2) to 4+3=7 (Grade group 3) with targeted biopsy in 1 of these 3 patients.
Conclusions: Fluciclovine PET/CT fusion targeted biopsy detected more patients with recurrence with fewer cores sampled (52 versus 246 cores). A larger series will be required to determine if targeted biopsy can augment or potentially replace template biopsy in the diagnosis of recurrent prostate cancer.
Biopsy Positivity Rate per Patient for Fluciclovine PET/Ultrasound Fusion Targeted Prostate Biopsy
}, 
URL = {http://jnm.snmjournals.org/content/59/supplement_1/1481.abstract}, 
journal = {Journal of Nuclear Medicine} 
}