From the Department of Radiology, University of Texas, Southwestern Medical Center, Dallas, TX.
Clin Nucl Med. 2022 Dec 1;47(12):1061-1062. doi: 10.1097/RLU.0000000000004373. Epub 2022 Aug 26.
An 83-year-old man with castrate-resistant prostate cancer underwent an 18 F-fluciclovine PET/CT scan, which was negative for local disease recurrence or locoregional lymphadenopathy, but there were multiple fluciclovine-avid bone metastases. In addition, mildly avid bilateral adrenal nodules were thought to be benign. However, on follow-up PET/CT 10 months later, while on additional therapy with enzalutamide, the bilateral nodules became mass lesions with interval decreased fluciclovine avidity. Adrenal metastases were suspected given their rapid growth, with subsequent CT-guided biopsy revealing metastatic prostate cancer without tumor necrosis. This false-negative case highlights the diagnostic challenge of fluciclovine PET in characterizing adrenal lesions.
一位 83 岁的去势抵抗性前列腺癌患者接受了 18 F-氟丁氨酸 PET/CT 扫描，结果未见局部疾病复发或局部淋巴结病，但有多处氟丁氨酸摄取的骨转移。此外，双侧肾上腺结节轻度摄取被认为是良性的。然而，在 10 个月后的后续 PET/CT 检查中，在接受恩扎卢胺的额外治疗时，双侧结节变成了肿块病变，氟丁氨酸摄取减少。由于其快速生长，怀疑为肾上腺转移，随后进行 CT 引导下活检显示转移性前列腺癌，无肿瘤坏死。这个假阴性病例突出了氟丁氨酸 PET 在描述肾上腺病变方面的诊断挑战。
