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A case of a patient with biochemical recurrence and inadequate results of suspected bone metastases in imaging methods — will [68Ga]Ga-PSMA-11 PET/CT give us an answer?
, 34, 5, 5, 1
Affiliations- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Methodology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
- 1st Department of Cardiology, Doctoral School, Medical University of Warsaw, Warsaw, Poland
- Nuclear Medicine Laboratory Nukleomed, Warsaw, Poland
open access
Abstract
We present a case of a 79-year-old asymptomatic patient with prostate adenocarcinoma, Gleason score 9 (4 + 5), with the initial prostate-specific antigen (PSA) level of 17 ng/mL, treated with radiotherapy and hormonotherapy, who was diagnosed with the rapid growth of PSA levels up to 78.8 ng/mL. Due to suspected bone metastases, first, bone scintigraphy was performed. However, it showed only one intense “hot” lesion in the Th7 projection. This image was not consistent with a high level of PSA, for which reason a computed tomography (CT) scan was performed. It revealed lytic metastasis in Th7 and one more suspicious change in L2, which still was inconsistent with the patient’s clinical picture. The patient was referred for [68Ga]Ga-PSMA-11 PET/CT. It showed an uncountable number of foci of increased marker accumulation in bones, mostly without visible change in CT examination. This case showed that the clinical results and suspicions of the advancement of a patient’s disease are still the most important data in care and therapy planning.
Abstract
We present a case of a 79-year-old asymptomatic patient with prostate adenocarcinoma, Gleason score 9 (4 + 5), with the initial prostate-specific antigen (PSA) level of 17 ng/mL, treated with radiotherapy and hormonotherapy, who was diagnosed with the rapid growth of PSA levels up to 78.8 ng/mL. Due to suspected bone metastases, first, bone scintigraphy was performed. However, it showed only one intense “hot” lesion in the Th7 projection. This image was not consistent with a high level of PSA, for which reason a computed tomography (CT) scan was performed. It revealed lytic metastasis in Th7 and one more suspicious change in L2, which still was inconsistent with the patient’s clinical picture. The patient was referred for [68Ga]Ga-PSMA-11 PET/CT. It showed an uncountable number of foci of increased marker accumulation in bones, mostly without visible change in CT examination. This case showed that the clinical results and suspicions of the advancement of a patient’s disease are still the most important data in care and therapy planning.
Keywords
PSMA; recurrent prostate cancer; bone metastases; [68Ga]Ga-PSMA-11
About this articleTitle
A case of a patient with biochemical recurrence and inadequate results of suspected bone metastases in imaging methods — will [68Ga]Ga-PSMA-11 PET/CT give us an answer?
Journal
Issue
Vol 26 (2023): Continuous Publishing
Article type
Clinical vignette
Pages
74-76
Published online
2023-05-25
Page views
1738
Article views/downloads
361
DOI
Pubmed
Bibliographic record
Nucl. Med. Rev 2023;26:74-76.
Keywords
PSMA
recurrent prostate cancer
bone metastases
[68Ga]Ga-PSMA-11
Authors
Kacper Pelka
Aleksandra Bodys-Pelka
Elżbieta Świątek-Rawa
Krzysztof Toth
Jolanta Kunikowska
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