Diffuse bone metastases on (68)Ga-PSMA PET-CT in a patient with prostate cancer and normal bone scan.
A 75-year-old patient was diagnosed with a Gleason 9 prostate carcinoma. His PSA level was 50.4 ng/ml. Routine bone scintigraphy was negative for metastasis (a). Due to the high tumour grading and relatively high PSA level, (68)Ga-PSMA PET-CT was ordered to rule out distant metastases. This scan showed numerous skeletal lesions with high tracer accumulation as sign of diffuse osseous metastases (b). On low-dose CT there were no signs of sclerosis (c). (68)Ga-PSMA PET-CT also showed high uptake in the prostate and in para-iliac and para-aortal lymph nodes, without lymph node enlargement. No bone biopsy was obtained to confirm the metastases. Due to this result, the treatment plan was changed to systemic therapy, instead of local therapy.
Department of Nuclear Medicine, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands. j.lavalaye@antoniusziekenhuis.nl.
J
J
Lavalaye
Department of Nuclear Medicine, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands.
P
P
Kaldeway
Department of Urology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands.
H H E
HH
van Melick
D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D004058:Diffusion; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005709:Gallium Isotopes; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D009842:Oligopeptides; D000072078:Positron Emission Tomography Computed Tomography; D011471:Prostatic Neoplasms / Q000473:pathology*
D005709:Gallium Isotopes; D005710:Gallium Radioisotopes; D009842:Oligopeptides; C000718244:gallium 68 PSMA-11; D004492:Edetic Acid
68Ga-PSMA; PET-CT; Prostate cancer