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While studies compared [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-PSMA-11 and [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine, data on\n                      <jats:sup>18<\/jats:sup>\n                      F-labelled PSMA-ligands versus [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine in patients with low prostate-specific antigen (PSA) levels (&lt;\u20092 ng\/mL) are limited. This study compared the detection rates of [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine and [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL PET\/CT in patients with BCR after robot-assisted radical prostatectomy (RARP). Secondary objectives included stratifying detection rates by PSA level, anatomical regions and assessing inter-observer agreement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, single-center study, patients with BCR (PSA 0.2-2.0 ng\/mL) underwent both [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine and [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL PET\/CT within 15 days. Three blinded nuclear medicine experts independently reviewed all scans. Lesions were classified as positive or negative in predefined regions (i.e., prostate bed, pelvic and extra-pelvic lymph nodes, bone, and visceral). Discrepancies were resolved by consensus, defined as majority agreement (\u2265\u20092\/3 readers). Inter-observer agreement was assessed using Fleiss\u2019 kappa.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall scan positivity was 44% (22\/50 patients) for [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL PET\/CT and 24% (12\/50) for [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine PET\/CT (p\u2009\n                      <jats:italic>=<\/jats:italic>\n                      \u20090.018). Detection rates increased with rising PSA levels for both tracers. Local recurrence was detected by both tracers in 16% (8\/50) of patients. Metastatic disease detection rates for [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL versus [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine were 22% vs. 8.0% for pelvic lymph nodes (p\u2009\n                      <jats:italic>=<\/jats:italic>\n                      \u20090.016), and 6.0% versus 2.0% for distant metastases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.50), respectively. Inter-observer agreement was moderate for both tracers (\u03ba\u2009=\u20090.59 for [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL and \u03ba\u2009=\u20090.55 for [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study demonstrated the superiority of [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL over [\n                      <jats:sup>18<\/jats:sup>\n                      F]Fluciclovine in detecting pelvic lymph node metastases in patients presenting with BCR after RARP at low PSA levels. These findings suggest the potential of [\n                      <jats:sup>18<\/jats:sup>\n                      F]DCFPyL PET\/CT to facilitate earlier and more personalized salvage treatment strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07816-3","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:08:07Z","timestamp":1772251687000},"page":"4414-4423","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["[18F]Fluciclovine PET\/CT versus [18F]DCFPyL PET\/CT in patients with biochemical recurrence of prostate cancer after robot-assisted radical prostatectomy: a prospective, single-center, single-arm, comparative imaging trial"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4590-6589","authenticated-orcid":false,"given":"Wietske I.","family":"Luining","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 N.","family":"Vis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten L.","family":"Donswijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose C. 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Informed consent was obtained from all individual participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}