¹⁸F-Fluciclovine is a novel PET/CT tracer. This blinded image evaluation (BIE) sought to demonstrate that, after limited training, readers naïve to ¹⁸F-fluciclovine could interpret ¹⁸F-fluciclovine images from subjects with biochemically recurrent prostate cancer with acceptable diagnostic performance and reproducibility. The primary objectives were to establish individual readers’ diagnostic performance and the overall interpretation (2/3 reader concordance) compared with standard-of-truth data (histopathology or clinical follow-up) and to evaluate interreader reproducibility. Secondary objectives included comparison to the expert reader and assessment of intrareader reproducibility. Methods: ¹⁸F-Fluciclovine PET/CT images (n = 121) and corresponding standard‐of‐truth data were collected from 110 subjects at Emory University using a single-time-point static acquisition starting 5 min after injection of approximately 370 MBq of ¹⁸F-fluciclovine. Three readers were trained using standardized interpretation methodology and subsequently evaluated the images in a blinded manner. Analyses were conducted at the lesion, region (prostate, including bed and seminal vesicle, or extraprostatic, including all lymph nodes, bone, or soft-tissue metastasis), and subject level. Results: Lesion-level overall positive predictive value was 70.5%. The readers’ positive predictive value and negative predictive value were broadly consistent with each other and with the onsite read. Sensitivity was highest for readers 1 and 2 (68.5% and 63.9%, respectively) whereas specificity was highest for reader 3 (83.6%). Overall, prostate-level sensitivity was high (91.4%), but specificity was moderate (48.7%). Interreader agreement was 94.7%, 74.4%, and 70.3% for the lesion, prostate, and extraprostatic levels, respectively, with associated Fleiss’ κ-values of 0.54, 0.50, and 0.57. Intrareader agreement was 97.8%, 96.9%, and 99.1% at the lesion level; 100%, 100%, and 91.7% in the prostate region; and 83.3%, 75.0%, and 83.3% in the extraprostatic region for readers 1, 2, and 3, respectively. Concordance between the BIE and the onsite reader exceeded 75% for each reader at the lesion, region, and subject levels. Conclusion: Specific training in the use of standardized interpretation methodology for assessment of ¹⁸F-fluciclovine PET/CT images enables naïve readers to achieve acceptable diagnostic performance and reproducibility when staging recurrent prostate cancer.

¹⁸ F-氟氯洛维汀是一种新颖的PET / CT示踪剂。这项盲目图像评估（BIE）试图证明，经过有限的培训，即使天真的¹⁸ F-氟尿嘧啶的读者也可以以可接受的诊断性能和可重复性来解释具有生化复发性前列腺癌的受试者的¹⁸ F-氟氯clovine图像。主要目标是建立与真实标准数据（组织病理学或临床随访）相比，各个读者的诊断性能和总体解释（2/3读者一致性），并评估阅读者之间的可重复性。次要目标包括与专家阅读器进行比较，以及评估阅读器内部的可重复性。方法： ^18张F-氟西洛维汀PET / CT图像（n = 121），并在注射约370 MBq的¹⁸ F-氟氯环戊烷后5分钟内使用单时间点静态采集，从Emory大学的110名受试者中收集了相应的真实标准数据。使用标准解释方法对三名读者进行了培训，随后以盲法评估了图像。在病变，区域（前列腺，包括床和精囊，或前列腺外，包括所有淋巴结，骨或软组织转移）和受试者水平进行分析。结果：病变水平总体阳性预测值为70.5％。读者的正面预测价值和负面预测价值彼此之间以及在现场阅读时都大致一致。读者1和2的敏感性最高（分别为68.5％和63.9％），而读者3的特异性最高（83.6％）。总体而言，前列腺水平的敏感性高（91.4％），但特异性中等（48.7％）。病灶，前列腺和前列腺外水平的读者间一致性分别为94.7％，74.4％和70.3％，相关的Fleissκ值为0.54、0.50和0.57。病变水平的阅读器内一致性分别为97.8％，96.9％和99.1％；前列腺区域为100％，100％和91.7％；分别位于阅读器1、2和3的前列腺外区域的83.3％，75.0％和83.3％。结论：使用标准化的解释学方法评估¹⁸ F-flucloclovinevine PET / CT图像的专门培训使幼稚的读者在分期复发性前列腺癌时可以获得可接受的诊断性能和可重复性。