68Ga-DOTATOC and 68Ga-PSMA PET/CT Unmasked a Case of Prostate Cancer With Neuroendocrine Differentiation. (December 2016)

• Record Type: Journal Article
• Authors: Chen, Sirong; Cheung, Shing Kee; Wong, Ka-nin; Wong, Kwok Kee; Ho, Chi-lai
• Is Part Of: Clinical nuclear medicine. Volume 41:Number 12(2016)
• Publication Date: 2016-12
• Subjects: 68Ga-DOTATOC -- 68Ga-PSMA -- neuroendocrine differentiation -- prostate cancer -- PSA -- chromogranin A; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000001419
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Abstract: A bedridden 90-year-old man with fever and elevated prostate-specific antigen (PSA) (49 ng/mL) was referred for differentiation between infection and tumor. 18 F-FDG PET/CT was negative for infection, but 68 Ga-PSMA PET/CT showed multiple lesions in prostate gland with infiltration to bladder wall and seminal vesicle, consistent with locally advanced prostate cancer. The lesion with the highest 68 Ga-PSMA uptake was strongly avid for 68 Ga-DOTATOC, suggesting neuroendocrine tumor differentiation. After hormonal therapy, PSA normalized, but chromogranin-A increased (from 251 to 398 ng/mL), inferring progression of neuroendocrine tumor differentiation. Advanced prostate cancer may require investigation for pathological neuroendocrine transformation, although PSA may suggest improvement.