Initial Experience with Axumin (Flucicovine F18) Positron Emission Tomography in Selecting Onco-intervention at a Community

Purpose: Our objective is to elucidate indications of F-18-fluciclovine (Axumin) positron emission tomography (PET) in intervention radiology. We discuss the patient preparation, image acquisition, normal physiologic distribution, diagnostic pearls, and pitfalls of using Axumin PET in management of patients with suspected recurrent prostate cancer. 18-Fluorodeoxyglucose (18-FDG), or sodium 18 fluoride (NaF18), is not effective in prostate cancer diagnosis and not approved for initial prostate cancer staging.

Materials and Methods: Axumin PET scans were performed in patients suspected for clinical recurrence based on elevated prostate specific antigen levels after prior treatment. A total of seven cases of Axumin PET-positive patients suspected for recurrence were included. These patients underwent various intervention procedures in radiology, including bone biopsy and lymph node biopsy. The propose is to focus on emerging tool Axumin PET on prostate onco-intervention.

Results: Three cases were positive for bone metastasis not evident on routine bone scan. One patient was positive for recurrence of malignancy of the prostate bed, and there were three cases of lymph node metastasis not suspected on routine computed tomography and magnetic resonance imaging.

Conclusions: Fluciclovine (Axumin) provides a great clinical tool for urologists, radiation oncologists, and oncologists in the overall clinical management of patients.