2884. Diagnostic Performance of 18-F-Fluciclovine PET/CT Detecting Metastatic Bone Disease With Pathological Correlation
Authors * Denotes Presenting Author
  1. Moataz Soliman; Northwestern University
  2. Yuri Velichko; Northwestern University
  3. Hatice Savas; Northwestern University
  4. Vidushani Perera *; Northwestern University
  5. Maryam Yousefi; Northwestern University
Evaluate the diagnostic performance of 18F-fluciclovine PET/CT for detection of osseous metastatic disease in patients with prostate cancer against histological standards of truth.

Materials and Methods:
A retrospective query was performed to identify all patients who underwent 18F-fluciclovine and bone biopsy at our institution between January 2017 and January 2021. A total of 44 patients met inclusion criteria. Two radiologists with 5 and 15 years of experience, who were blinded to pathologic results reviewed imaging data and reported radiotracer activity suspicious for osseous metastatic disease with high or low confidence level and anatomical side. Consensus reading was performed when results were discordant. A final consensus decision was compared with the biopsy results.

A total of 44 bone sites were biopsied in 44 eligible patients. The overall bone metastasis detection sensitivity, specificity, PPV, and NPP were 77.7% (59, 97), 42.3% (23, 61), 48.2% (30, 66), and 73% (51, 96) respectively. Fifteen cases were false positive on 18-F fluciclovine PET/CT, 73% (11/15) corresponded to sclerotic lesions on CT. On the other hand, 4 cases were found to be false negative.

18-F fluciclovine PET/CT is sensitive for detection metastatic bone disease. However, in our experience, given the poor specificity a positive result should be interpreted carefully.