68ga-dotanoc and Prostatic-Neoplasms

Ga-PSMA PET/CT is the upcoming imaging modality for staging, restaging and response assessment of prostate cancer. However, due to neuroendocrine differentiation in some of patients with prostate cancer, they express somatostatin receptors instead of prostate specific membrane antigen. This can be exploited and other modalities like Ga-DOTANOC PET/CT and F-FDG PET/CT should be used in such cases for guiding management. We hereby discuss a similar case of 67-year-old man of adenocarcinoma prostate with neuroendocrine differentiation, which shows the potential pitfall of Ga-PSMA PET/CT imaging and benefit of Ga-DOTANOC PET/CT and F-FDG PET/CT in such cases.

Topics: Adenocarcinoma; Aged; Edetic Acid; Fluorodeoxyglucose F18; Gallium Isotopes; Gallium Radioisotopes; Humans; Male; Neuroendocrine Tumors; Oligopeptides; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms

We report on a 62-year-old man with metastatic prostate cancer (cT3b N1) diagnosed in 2011, treated with total androgen blockage with flutamide and goserelin acetate (Zoladex). He presented with left suprascapular swelling and low-back pain after being asymptomatic for 5 years. His prostate-specific antigen was 0.049 ng/mL. F-NaF PET-CT and Ga-PSMA scan were negative, whereas Ga-DOTA NOC scan done after 10 days showed multiple somatostatin-avid hepatic and lymph node metastasis.

Topics: Edetic Acid; Gallium Isotopes; Gallium Radioisotopes; Humans; Male; Middle Aged; Neuroendocrine Tumors; Oligopeptides; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Sodium Fluoride