Fluciclovine (18F)

Fluciclovine (18F), also known as FACBC (anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid), is a synthetic amino acid radiopharmaceutical used in positron emission tomography (PET) imaging. It is primarily employed in the detection and localization of recurrent prostate cancer in men with elevated prostate-specific antigen (PSA) levels following primary treatment, such as radical prostatectomy or radiation therapy.

Fluciclovine (18F) is an analog of the naturally occurring amino acid leucine. Cancer cells, including prostate cancer cells, exhibit increased amino acid transport compared to normal cells to support their rapid growth and proliferation. Fluciclovine (18F) is taken up by these cancer cells via amino acid transporters, particularly LAT1 (L-amino acid transporter 1), resulting in increased concentrations of the radiopharmaceutical in tumor tissue.

The 18F radionuclide emits positrons, which annihilate with electrons in the body, producing pairs of gamma rays that are detected by the PET scanner. The resulting images provide information about the distribution and uptake of Fluciclovine (18F), allowing physicians to identify areas of suspected cancer recurrence.

The clinical use of Fluciclovine (18F) PET imaging has demonstrated improved sensitivity and specificity compared to conventional imaging modalities, such as bone scans and CT scans, for detecting recurrent prostate cancer at low PSA levels. This can lead to more accurate staging, treatment planning, and monitoring of disease progression.

The most common side effects reported with Fluciclovine (18F) are generally mild and transient. These can include injection site reactions, such as pain or swelling, and nausea. Allergic reactions are rare but possible.

Fluciclovine (18F) is administered intravenously, and patients are typically instructed to hydrate well before and after the scan to facilitate excretion of the radiopharmaceutical. The images are usually acquired within an hour of injection.

Pharmacokinetics: Fluciclovine (18F) exhibits rapid distribution and clearance from the body. Excretion is primarily via the kidneys.

Regulatory Status: Fluciclovine (18F) is approved for use in the United States and other countries for the detection of recurrent prostate cancer.