前列腺癌脑转移：用PSMA PET/CT监测治疗反应。
Prostate cancer brain metastases: Monitoring response to treatment with PSMA PET/CT.
作者信息
Al-Zubaidi Anas, Bezold Samuel, Bhargava Peeyush, Villanueva-Meyer Javier
机构信息
Department of Radiology, University of Texas Medical Branch, Galveston TX 77555, USA.
出版信息
Radiol Case Rep. 2024 Mar 23;19(6):2367-2370. doi: 10.1016/j.radcr.2024.02.110. eCollection 2024 Jun.
Prostate cancer brain metastases are rare but increasingly recognized with prostate-specific membrane antigen (PSMA) PET/CT. Distinguishing tumor response from postradiation changes are challenging on MRI. PSMA PET/CT may clarify equivocal brain lesions after radiotherapy. A 71-year-old man with metastatic prostate cancer developed 2 new brain lesions on PSMA PET/CT. Lesions were high PSMA-avid and MRI follow up showed enhancing masses with edema, consistent with metastases. He underwent whole-brain radiation. Follow-up PSMA PET/CT after radiotherapy demonstrated significantly decreased lesion size and activity, with activity lower than blood pool, indicating a treatment response. MRI also showed near-resolution of the lesions. This case highlights the potential utility of PSMA PET/CT for detecting prostate cancer brain metastases and monitoring treatment response. PSMA PET/CT provides valuable complementary information to MRI for managing irradiated prostate cancer brain metastases.
前列腺癌脑转移罕见，但随着前列腺特异性膜抗原（PSMA）PET/CT的应用，其越来越被认识到。在MRI上区分肿瘤反应和放疗后改变具有挑战性。PSMA PET/CT可能有助于明确放疗后不明确的脑病变。一名71岁的转移性前列腺癌男性患者在PSMA PET/CT上出现了2个新的脑病变。病变PSMA摄取高，MRI随访显示肿块强化并伴有水肿，符合转移瘤表现。他接受了全脑放疗。放疗后的PSMA PET/CT显示病变大小和活性显著降低，活性低于血池，提示治疗有效。MRI也显示病变几乎消退。该病例突出了PSMA PET/CT在检测前列腺癌脑转移和监测治疗反应方面的潜在效用。PSMA PET/CT为处理接受放疗的前列腺癌脑转移提供了有价值的补充信息，可补充MRI的不足。
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