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Imber BS, Yu KKH, Abida W, Pike LRG, Grkovski M, Kaley TJ, Morris MJ, Bodei L, Nosov A, Dunphy MPS, Schöder H, Fox JJ, Rosenblum M, Bale T, Krebs S. Symptomatic Prostate-Specific Membrane Antigen PET-Positive Radionecrosis After Multimodality Brain Metastasis-Directed Treatment Including [ 177Lu]Lu-PSMA-617. J Nucl Med 2025:jnumed.124.269175. [PMID: 40049744 DOI: 10.2967/jnumed.124.269175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 02/20/2025] [Indexed: 03/19/2025] Open
Affiliation(s)
- Brandon S Imber
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York;
| | - Kenny Kwok Hei Yu
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Wassim Abida
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Luke R G Pike
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Milan Grkovski
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Thomas J Kaley
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael J Morris
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lisa Bodei
- Department of Radiology, Molecular Imaging, and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anton Nosov
- Department of Radiology, Molecular Imaging, and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark P S Dunphy
- Department of Radiology, Molecular Imaging, and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Heiko Schöder
- Department of Radiology, Molecular Imaging, and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Josef J Fox
- Department of Radiology, Molecular Imaging, and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc Rosenblum
- Department of Pathology, Neuropathology Service, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Tejus Bale
- Department of Pathology, Neuropathology Service, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Simone Krebs
- Department of Radiology, Molecular Imaging, and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Nuclear Medicine and Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
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Al-Zubaidi A, Bezold S, Bhargava P, Villanueva-Meyer J. Prostate cancer brain metastases: Monitoring response to treatment with PSMA PET/CT. Radiol Case Rep 2024; 19:2367-2370. [PMID: 38559655 PMCID: PMC10979001 DOI: 10.1016/j.radcr.2024.02.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
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.
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Affiliation(s)
- Anas Al-Zubaidi
- Department of Radiology, University of Texas Medical Branch, Galveston TX 77555, USA
| | - Samuel Bezold
- Department of Radiology, University of Texas Medical Branch, Galveston TX 77555, USA
| | - Peeyush Bhargava
- Department of Radiology, University of Texas Medical Branch, Galveston TX 77555, USA
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