From the Division of Nuclear Medicine, Department of Radiology, McGill University, Montreal, Quebec, Canada.
Clin Nucl Med. 2018 Apr;43(4):250-251. doi: 10.1097/RLU.0000000000002009.
A 58-year-old man with Gleason 4+3 prostate cancer was initially treated by radical prostatectomy followed by salvage radiotherapy to the prostate bed for postoperative biochemical failure. One year later, F-fluorocholine PET/CT detected a pelvic lymph node recurrence, which was treated with radiation therapy and 6 months of androgen deprivation. PSA started to rise again 18 months later, but F-fluciclovine PET/CT failed to demonstrate the site of recurrence at a PSA of 0.63 ng/mL. However, Ga-PSMA PET/CT revealed a single positive 4-mm perirectal lymph node (PSA 0.80 ng/mL at time of scan), in retrospect anatomically apparent but negative on F-fluciclovine PET/CT.
一位 58 岁的男性，患有 Gleason 4+3 前列腺癌，最初接受了根治性前列腺切除术，随后对前列腺床进行挽救性放疗，以治疗术后生化失败。一年后，F-氟代胆碱 PET/CT 检测到盆腔淋巴结复发，采用放疗和 6 个月的雄激素剥夺治疗。18 个月后 PSA 再次升高，但 F-氟代胆碱 PET/CT 在 PSA 为 0.63ng/ml 时未能显示复发部位。然而，Ga-PSMA PET/CT 显示单个阳性 4mm 直肠旁淋巴结（扫描时 PSA 为 0.80ng/ml），回顾性分析解剖学上可见，但在 F-氟代胆碱 PET/CT 上为阴性。
