ABSTRACT
Fluorine 18 (18F) fluciclovine (anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid [FACBC]) is a radiolabeled amino acid analog that takes advantage of the amino acid transport upregulation in several types of cancer cells. FACBC is taken up to a greater extent in prostate cancer cells than in surrounding normal tissue, providing an opportunity for its use in cases of this common cancer. In 2016, the U.S. Food and Drug Administration found the accuracy of FACBC PET to be superior to that of other molecular imaging techniques and subsequently granted approval for its use in PET of recurrent prostate cancer. As FACBC is an 18F radiotracer, an on-site cyclotron is not required for its production. This feature enables the widespread clinical availability of this agent and, in turn, an opportunity for improved patient care. The clinical pharmacology and imaging features of FACBC are reviewed, and the role of this agent in the imaging of recurrent prostate cancer, within the context of research that supports its effectiveness, is discussed. The administration of and image acquisition facilitated by using FACBC, as compared with 18F fluorodeoxyglucose, which is more widely used, are described. In addition, the criteria for interpreting FACBC imaging findings are outlined, with emphasis on common causes of false-positive and false-negative findings. ©RSNA, 2019.
Subject(s)
Adenocarcinoma/secondary , Carboxylic Acids , Cyclobutanes , Fluorine Radioisotopes , Neoplasm Recurrence, Local/diagnostic imaging , Positron-Emission Tomography/methods , Prostatic Neoplasms/diagnostic imaging , Radiopharmaceuticals , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/metabolism , Adenocarcinoma/surgery , Aged , Amino Acids/metabolism , Biological Transport , Carboxylic Acids/pharmacokinetics , Cyclobutanes/pharmacokinetics , Diagnosis, Differential , Fluorine Radioisotopes/pharmacokinetics , Humans , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, Local/metabolism , Neoplasm Staging/methods , Organ Specificity , Positron Emission Tomography Computed Tomography , Prostatectomy , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/surgery , Prostatitis/diagnostic imaging , Radiopharmaceuticals/pharmacokineticsABSTRACT
Morel-Lavallee lesions (MLL) are rare, closed degloving injuries caused by trauma that delivers a shearing force to the soft tissue most commonly of the hip. If not treated in the acute and subacute setting these lesions are often complicated by re-accumulation of fluid, infection, or chronic pain. We present a unique case of a recurrent, massive medial knee/thigh MLL in which proper treatment was delayed due to initial diagnosis of a quadriceps contusion. We describe the ultrasound and magnetic resonance imaging findings of this patient and based on a review of recent literature propose that the initial management should have included early drainage/debridement, which likely could have prevented recurrence and significantly shortened the clinical course.
