Kitajima Kazuhiro, Yamamoto Shingo, Fujiwara Masayuki, Kawanaka Yusuke, Yamada Yusuke, Nagasawa Seiji, Shimatani Kimihiro, Hanasaki Takeshi, Taguchi Motohiro, Kanematsu Akihiro, Yamakado Koichiro
Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan.
Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan.
Case Rep Oncol. 2021 Mar 22;14(1):520-524. doi: 10.1159/000514191. eCollection 2021 Jan-Apr.
We here report 2 cases of castration-resistant prostate cancer (CRPC) observed two times on C-choline positron emission tomography computed tomography (PET/CT), which was useful to discriminate viable progressive osteoblastic bone metastasis from benign osteoblastic change induced by the treatment effect and to determine the viability of bone metastases, regardless of whether sclerosis was present or not. Because one case demonstrated disappearance of abnormal C-choline uptake of osteoblastic metastatic lesions after abiraterone therapy and no new lesions at other sites, suggesting nonviable bone metastases, we can assume a complete metabolic response. Because the other case demonstrated a decrease in the existing, abnormal C-choline uptake of osteoblastic metastatic lesions, but multiple new appearances of osteoblastic and nonosteoblastic lesions with abnormal C-choline uptake after radium-223 therapy suggesting multiple viable bone metastases, we can assume progressive metabolic disease. C-choline PET/CT could help in assessing the treatment response of bone metastases in patients with metastatic CRPC.
我们在此报告2例去势抵抗性前列腺癌（CRPC）患者，其在C胆碱正电子发射断层扫描计算机断层扫描（PET/CT）上被观察到两次，这有助于鉴别由治疗效应引起的良性成骨改变与存活的进行性成骨细胞性骨转移，并确定骨转移灶的活性，无论是否存在硬化。因为1例患者在阿比特龙治疗后成骨细胞性转移灶的异常C胆碱摄取消失，且其他部位无新病灶，提示骨转移灶无活性，我们可以认为是完全代谢缓解。因为另一例患者在镭-223治疗后，成骨细胞性转移灶现有的异常C胆碱摄取减少，但出现多个有异常C胆碱摄取的成骨和非成骨新病灶，提示多个存活的骨转移灶，我们可以认为是代谢性疾病进展。C胆碱PET/CT有助于评估转移性CRPC患者骨转移的治疗反应。
