Characterization of 18F-Fluciclovine PET Amino Acid Radiotracer in Resected Brain Metastasis

Inclusion Criteria:

1. Age ≥ 18 years

2. Performance status, Eastern Cooperative Oncology Group (ECOG) 0-3

3. Radiographic diagnosis of brain metastasis

4. Patient planned for surgical intervention for at least 1 metastasis

5. Patient planned for postoperative SRS

Male or female patients of reproductive potential need to employ two highly effective and acceptable forms of contraception for at least 4 weeks prior to screening and agreement to use such a method during study participation and for an additional 1 week after post-treatment 18F-Fluciclovine PET/CT. Highly effective and acceptable forms of contraception are:

• Male condom plus spermicide

• Cap plus spermicide

• Diaphragm plus spermicide

• Copper T

• Progesterone T

• Levonorgestrel-releasing intrauterine system (e.g., Mirena®)

• Implants

• Hormone shot or injection

• Combined pill

• Mini-pill

• Patch

Postmenopausal people on the study (that will not need contraception) is defined as at least one of the following:

• Amenorrhoeic for 1 year or more following cessation of exogenous hormonal treatments

• Luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in thepostmenopausal range for women under 50

• Radiation-induced oophorectomy with last menses > 1 year ago

• Chemotherapy-induced menopause with >1 year interval since last menses

• Surgical sterilization (bilateral oophorectomy or hysterectomy).

Exclusion Criteria:

1. Prior anaphylactic reaction to 18F-Fluciclovine

2. Evidence of leptomeningeal disease

3. Prior whole-brain radiation therapy

4. Contraindication to MRI (e.g., due to safety reasons, such as presence of apacemaker)

5. Pregnant at the expected time of 18F-fluciclovine administration

6. Expecting to be breastfeeding at the time of 18F-Fluciclovine and unwilling to stopbreast-feeding for 24 hours. Temporary cessation of breastfeeding 24 hours after thetime of imaging is allowed.