Pretreatment Staging of High-Risk Prostate Cancer With 18F-Fluciclovine PET/MRI
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Prostate Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/20/2019 |
| Start Date: | November 8, 2017 |
| End Date: | June 2019 |
There is great need for improved preoperative imaging in men with high-risk prostate cancer.
Investigators propose to develop and validate an optimized simultaneous PET/MRI protocol for
local, regional and whole body preoperative staging in a single imaging session using the
amino acid PET tracer, F-18 fluciclovine. Despite advances in the diagnosis and treatment of
prostate cancer, the preoperative staging of men with prostate carcinoma (PCa) is currently
problematic. Conventional imaging is falsely negative for regional lymph node metastases in a
substantial fraction of men. In particular, approximately 35% of men with high-risk prostate
cancer will have biochemical recurrence even after optimal surgical resection. A major
benefit of simultaneous acquisition of a multiparametric prostate MRI (mpMRI) and F-18
fluciclovine PET includes having the patient undergo a single imaging study which provides
both anatomic and molecular characterization of the tumor, including metastases which would
potentially be missed by conventional anatomic imaging and size criteria. Additionally,
simultaneous acquisition will improve co-registration of the PET and MR data which is
valuable for small lesions and in anatomically complex regions. Although the use of
fluciclovine in the characterization of the primary PCa remains to be established, the
anatomic detail provided by conventional mpMRI will complement the detection of small volume
metastatic disease by fluciclovine PET. Additionally, the use of hybrid PET/MRI technology
allows for the assessment of dynamic tracer uptake and washout during the whole body and
regional PET/MRI scan, which may demonstrate the ability to increase detection of the primary
PCa on fluciclovine PET. If F-18 fluciclovine PET/MRI can reliably and accurately detect
nodal metastases in high-risk prostate cancer patients, surgeons may use this new technology
to develop new treatment algorithms for the optimal management of these patients.
Investigators propose to develop and validate an optimized simultaneous PET/MRI protocol for
local, regional and whole body preoperative staging in a single imaging session using the
amino acid PET tracer, F-18 fluciclovine. Despite advances in the diagnosis and treatment of
prostate cancer, the preoperative staging of men with prostate carcinoma (PCa) is currently
problematic. Conventional imaging is falsely negative for regional lymph node metastases in a
substantial fraction of men. In particular, approximately 35% of men with high-risk prostate
cancer will have biochemical recurrence even after optimal surgical resection. A major
benefit of simultaneous acquisition of a multiparametric prostate MRI (mpMRI) and F-18
fluciclovine PET includes having the patient undergo a single imaging study which provides
both anatomic and molecular characterization of the tumor, including metastases which would
potentially be missed by conventional anatomic imaging and size criteria. Additionally,
simultaneous acquisition will improve co-registration of the PET and MR data which is
valuable for small lesions and in anatomically complex regions. Although the use of
fluciclovine in the characterization of the primary PCa remains to be established, the
anatomic detail provided by conventional mpMRI will complement the detection of small volume
metastatic disease by fluciclovine PET. Additionally, the use of hybrid PET/MRI technology
allows for the assessment of dynamic tracer uptake and washout during the whole body and
regional PET/MRI scan, which may demonstrate the ability to increase detection of the primary
PCa on fluciclovine PET. If F-18 fluciclovine PET/MRI can reliably and accurately detect
nodal metastases in high-risk prostate cancer patients, surgeons may use this new technology
to develop new treatment algorithms for the optimal management of these patients.
Inclusion Criteria:
- High-risk biopsy-proven treatment-naïve prostate adenocarcinoma (Gleason score ≥ 8 and/or
serum PSA > 20)
Exclusion Criteria:
- Inability to tolerate or undergo PET/MRI
- Previous or current hematologic or lymphatic disorder (including leukemia, lymphoma,
Castleman's disease, etc.)
- Recurrent prostate adenocarcinoma
- Known visceral, osseous, or extrapelvic metastases prior to fluciclovine-PET/MRI
- Known allergy to glucagon or gadolinium-based contrast
We found this trial at
1
site
Birmingham, Alabama 35233
Principal Investigator: Samuel J Galgano, MD
Phone: 205-934-1388
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