医学
前列腺癌
磁共振成像
骨转移
正电子发射断层摄影术
放射科
前列腺
转移
贪婪
活检
病变
核医学
癌症
病理
抗原
内科学
免疫学
作者
Hicham Moukaddam,Ghida Saheb,Nedal Omran,Nour El Ghawi,Alain S. Abi‐Ghanem,Mohamad Haidar
标识
DOI:10.3389/fnume.2024.1451848
摘要
Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is an imaging technique that has demonstrated high sensitivity and specificity in detecting prostate cancer and its metastasis, especially in the bones. This case describes a 60-year-old man who presented for increased prostate-specific antigen (PSA) level and underwent [ 68 Ga]gallium-PSMA-11 PET/CT imaging for better disease assessment. 68 Ga-PSMA-11 PET/CT revealed numerous radiotracer-positive lesions in both prostate lobes with associated sclerotic lesions on L4 and L5, but only L5 showed increased radiotracer avidity raising the possibility of metastasis. Magnetic Resonance Imaging (MRI) raises the possibility of aggressive MODIC type 1 lesion vs. infectious/inflammatory process. A biopsy of the radiotracer avid area was performed and showed no evidence of metastasis. The final diagnosis was aggressive MODIC type 1, in keeping with the false positive result of 68 Ga-PSMA-11 PET/CT. This example demonstrates the possible limitations of 68 Ga-PSMA-11 PET/CT, particularly in detecting bone metastases, and emphasizes the need for cautious interpretation and additional study to improve its diagnostic accuracy. Understanding and resolving these limitations is critical for increasing the accuracy of PSMA PET/CT in prostate cancer management.
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