Clinical guidelines support the use of 18F-fluciclovine as an imaging option for prostate cancer recurrence or progression
National Comprehensive Cancer Network® (NCCN)®1
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Prostate Cancer Version v1.2022 state that F 18 fluciclovine PET/CT or PET/MRI should be considered as options in the clinical workup of patients with recurrence or progression of nonmetastatic prostate cancer.
To view the full NCCN Guidelines® for Prostate Cancer Version v1.2022, visit www.nccn.org.
The ASCO Clinical Practice Guideline2
Optimum Imaging Strategies for Advanced Prostate Cancer states that for patients with rising PSA after local treatment who are considered suitable for salvage therapy, next-generation imaging (NGI), including F 18 fluciclovine PET, should be considered if conventional imaging is negative for metastasis.
To view the full ASCO Guidelines, including pocket guide and web-based flip chart, please visit www.asco.org/research-guidelines/quality-guidelines/guidelines.
American College of Radiology (ACR)3
The ACR Appropriateness Criteria® for Post-Treatment Follow-up of Prostate Cancer categorizes Axumin PET/CT skull base to mid-thigh as “usually appropriate” for post-treatment follow-up in certain situations.*
To view the full ACR Appropriateness Criteria® for Post-Treatment Follow-up of Prostate Cancer, visit www.acr.org.
The RADAR III Group4
The group discussed the potential impact of NGIs on treatment options based on earlier detection of disease. The RADAR III Group unanimously recommended NGI techniques for select patients suspected of disease progression based on laboratory (biomarker) values, comorbidities, and symptoms and that F 18 fluciclovine PET/CT is favorable due to the combination of availability, specificity, and sensitivity.
To review the full RADAR III review article, visit www.auajournals.org/doi/pdf/10.1016/j.juro.2018.05.164.
*Variant 1: Prostate cancer follow-up. Status post radical prostatectomy. Clinical concern for residual or recurrent disease; Variant 2: prostate cancer follow-up. Clinical concern for residual or recurrent disease after nonsurgical local and pelvic treatments; Variant 3: Metastatic prostate cancer treated by systemic therapy (androgen deprivation therapy [ADT], chemotherapy, and immunotherapy).
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Guideline for Prostate Cancer (Version v1.2022). © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed September 17, 2021. To view the most recent and complete version of the guideline, go to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
- Trabulsi EJ, Rumble RB, Jadvar H, et al. Optimum imaging strategies for advanced prostate cancer: ASCO guideline. J Clin Oncol. 2020;38(17):1963-1996.
- Expert Panel on Urologic Imaging; Froemming AT, Verma S, Eberhardt SC, et al. ACR Appropriateness Criteria® Post-treatment Follow-up Prostate Cancer. J Am Coll Radiol. 2018;15(5S):S132-S149.
- Crawford ED, Koo PJ, Shore N, et al. A clinician’s guide to next generation imaging in patients with advanced prostate cancer (RADAR III). J Urol. 2018;201:682-692.