Imaging Discordance Between [⁶⁸Ga]-PSMA PET and [¹⁷⁷Lu]-PSMA SPECT in mCRPC
Clinical Nuclear Medicine, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/rlu.0000000000006293
- Dergi Adı: Clinical Nuclear Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: post-therapy SPECT/CT, prostate cancer, PSMA PET/CT, radioligand therapy, [177Lu]-PSMA-617, [68Ga]-PSMA-11
- Hacettepe Üniversitesi Adresli: Evet
Özet
PSMA PET/CT is commonly used for selecting candidates for [¹⁷⁷Lu]-PSMA radioligand therapy (LuPSMA RLT). However, discrepancies may occur due to pharmacokinetic and biodistribution differences between [⁶⁸Ga]-PSMA-11 and [¹⁷⁷Lu]-PSMA-617 ligands. Such discordance risks underestimating disease burden and excluding eligible patients. We present a case of metastatic castration-resistant prostate cancer (mCRPC) in whom a PSMA-negative adrenal lesion on PET exhibited significant LuPSMA uptake post-therapy and was subsequently confirmed as FDG-avid. Complementary stereotactic body radiotherapy (SBRT) achieved metabolic remission. This case highlights the clinical significance of integrating post-therapy LuPSMA imaging and FDG PET/CT with systemic treatment to ensure accurate disease characterization and personalized management of PSMA−/FDG+ lesions in advanced prostate cancer.