Axumin Positron Emission Tomography: Novel Agent for Prostate Cancer Biochemical Recurrence

Prostate cancer remains one of the top common cancers in terms of incidence and cancer-related deaths. Approximately 1/3^rd cases develop biochemical recurrence during surveillance post-definite therapy. Multiple imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI) (including multiparametric prostate MRI), bone scan, and positron emission tomography (PET) using different tracers are being used for the characterization of the prostate cancer recurrence. CT and MRI do not provide physiological information, thus have lower sensitivity in detecting the metastasis. A bone scan has low sensitivity (depending on the prostate-specific antigen level) with low specificity as well. Among different PET tracers, Axumin PET appears to be the most promising tool. Axumin PET is Food and Drug Administration approved for the evaluation of prostate cancer biochemical recurrence. Several studies have shown that Axumin PET findings played a key role in treatment modification by finding otherwise undetected lesions. We briefly discuss the salient characteristics, imaging protocol and image interpretation criteria for Axumin PET in the workup of prostate cancer biochemical recurrence.