Interesting ImagesIsolated Intravascular Prostate Carcinoma Recurrence Confirmed With 18F-Fluciclovine PET/CT and MRIAgely, Ali MD*; Sharma, Akash MD, MBA*; Parent, Ephraim E. MD, PhD*; Nawaz, Anem MBBS†; Jain, Manoj K. MD*Author Information From the *Department of Radiology, Mayo Clinic, Jacksonville †Orange Park Medical Center, Orange Park, FL. Received for publication September 14, 2019; revision accepted February 5, 2020. Conflicts of interest and sources of funding: E. E. P. participates in research, funded in part by Blue Earth Diagnostics. None declared to all other authors. Correspondence to: Manoj K. Jain, MD, Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL. E-mail: Jain.Manoj@mayo.edu. Online date: April 23, 2020 Clinical Nuclear Medicine: June 2020 - Volume 45 - Issue 6 - p 442-443 doi: 10.1097/RLU.0000000000003011 Buy Metrics Abstract Late recurrence of prostate cancer after remission with prior radical prostatectomy is uncommon. This is a unique case of biochemical recurrence after being in remission for 12 years. The patient presented with swelling of the right lower extremity with pelvic MRI demonstrating an arterially enhancing filling defect in the right common iliac. An 18F-fluciclovine PET/CT showed corresponding increased intravascular radiotracer activity. Targeted biopsy of the intravascular lesion showed poorly differentiated carcinoma, suggestive of prostate origin. Although MRI evaluation is the mainstay for pelvic evaluation, characterization with 18F-fluciclovine PET/CT imaging adds high whole-body specificity and diagnostic accuracy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.