F-18 Fluciclovine PET Finds Hidden Prostate Cancer
New imaging may help patients with rising PSA levels whose cancer was not detected by standard PSMA-PET scans.
Updated on Oct. 29, 2026 in Cancer
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Researchers found that F-18 fluciclovine PET scans identified recurrent prostate cancer in 56% of patients who had previously received negative results from PSMA-PET imaging. This imaging approach prompted changes to clinical management plans for a majority of the 50 study participants.
Why it matters
Prostate cancer recurrence is often difficult to detect once PSA levels begin to rise, and this finding suggests a potential pathway for patients whose cancer remains hidden on standard PSMA-PET scans. Identifying the location of recurrence can help clinicians more accurately tailor treatment strategies.
A prospective trial of 50 patients with biochemical recurrence found that F-18 fluciclovine PET scans identified cancer in 56% of participants who had previously tested negative on PSMA-PET imaging. Results showed a 44% detection rate for PSA levels between 0.2 and 0.5 ng/mL.
The players
Oregon Health & Science University
A Portland-based public research university and academic health center.
The details
F-18 fluciclovine acts as a synthetic amino acid tracer that is taken up by prostate cancer cells, which often have high metabolic demands for amino acids. When detected by PET/CT imaging, this tracer can highlight areas of recurrent disease that might be missed by PSMA-targeting tracers. In this study, the imaging results led to altered treatment plans in 87% of patients with positive findings and 54% of those with negative findings.
Timeline
October 29, 2026: Study results were published in the Journal of Nuclear Medicine.
Health Landscape
While PSMA-PET has become the standard for staging, these findings highlight a diagnostic gap for some patients with biochemical recurrence. This research explores how complementary tracers can refine care for those whose cancer remains elusive under current imaging protocols.
If you are managing biochemical recurrence and have experienced negative PSMA-PET results, this study suggests it may be worth discussing alternative imaging tracers with your oncologist. Always consult with your medical team to determine if additional testing is appropriate based on your specific PSA levels and clinical history.
The takeaway
F-18 fluciclovine PET may offer a diagnostic alternative for patients whose prostate cancer is not detected by standard PSMA-PET scans. Patients concerned about rising PSA levels should speak with their urologist or oncologist about whether different imaging modalities could provide more clarity on their condition.
Further reading
For more on evolving diagnostic technologies, visit Cancer.
Source note: This article includes information reported by AuntMinnie.
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If a follow-up medical test shows new information, should you change your current treatment plan?
