A Hangover Under 177 Lu-PSMA-617 Therapy : A Red Flag for Brain 68 Ga-PSMA-11 PET/MRI?

Clin Nucl Med. 2024 Jun 1;49(6):582-583. doi: 10.1097/RLU.0000000000005126. Epub 2024 Feb 23.

Abstract

Leptomeningeal carcinomatosis in prostate cancer is extremely rare. Because of the low overall penetration of drugs into the brain and the prolonged survival of castration-resistant prostate cancer (CRPC) patients, a special attention should be paid to the appearance of neurological symptoms in long-term CRPC survivors. A patient suffering from a CRPC with bone metastases underwent 4 cycles of 177 Lu-PSMA (prostate-specific membrane antigen)-617. Starting from the third cycle, he reported an increasing feeling of a permanent hangover. A 68 Ga-PSMA-11 brain PET/MRI was carried out after the fourth cycle. It revealed intraparenchymatous brain metastases with intense uptake and evidences of leptomeningeal carcinomatosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain / diagnostic imaging
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / secondary
  • Dipeptides
  • Edetic Acid / analogs & derivatives
  • Gallium Isotopes*
  • Gallium Radioisotopes*
  • Heterocyclic Compounds, 1-Ring
  • Humans
  • Lutetium*
  • Magnetic Resonance Imaging*
  • Male
  • Multimodal Imaging
  • Positron-Emission Tomography*
  • Prostate-Specific Antigen*
  • Prostatic Neoplasms, Castration-Resistant / diagnostic imaging
  • Radioisotopes

Substances

  • Gallium Isotopes
  • gallium 68 PSMA-11
  • Gallium Radioisotopes
  • Lutetium
  • Dipeptides
  • Heterocyclic Compounds, 1-Ring
  • Edetic Acid
  • Radioisotopes
  • Lutetium-177
  • PSMA-617
  • Pluvicto
  • PSMA-11
  • Prostate-Specific Antigen