title: False-positive diagnosis of disease progression by magnetic resonance imaging for response assessment in prostate cancer with bone metastases: A case report and review of the pitfalls of images in the literature.
abstract: Bone metastases are common in prostate cancer. However, differentiating neoplastic from non-neoplastic alterations of bone on images is challenging. In the present report, a rare case of bone marrow reconversion on magnetic resonance imaging (MRI) assessment, which may lead to a false-positive diagnosis of disease progression of bone metastases in hormone-resistant prostate cancer, is presented. Furthermore, a review of the literature regarding the pitfalls of images for response assessment, including the 'flare' phenomenon on bone scintigraphy, computed tomography (CT), positron emission tomography/CT and marrow reconversion on MRI is also provided. These inaccuracies, which may lead to a premature termination of an efficacious treatment, should be carefully considered by the radiologists and oncologists involved in clinical trials. The case reported in the present study showed how to assess the early therapeutic response and select the appropriate treatment for the patient when these pitfalls are encountered on clinical images.
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, Shandong 250117, P.R. China.
authors.forename: Yi-Shan
authors.initials: YS
authors.lastname: Yu
authors.affiliation: Department of Radiology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, Shandong 250117, P.R. China.
authors.forename: Wan-Hu
authors.initials: WH
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, Shandong 250117, P.R. China.
authors.forename: Ming-Huan
authors.initials: MH
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, Shandong 250117, P.R. China.
authors.forename: Xue
authors.initials: X
authors.lastname: Meng
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, Shandong 250117, P.R. China.
authors.forename: L I
authors.initials: LI
authors.lastname: Kong
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, Shandong 250117, P.R. China.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Yu
keywords: marrow reconversion on magnetic resonance imaging; pitfalls of images; prostate cancer; ‘flare’ phenomenon