Stereotactic Body Radiation Therapy (SBRT)-Induced 68Ga-PSMA PET Bone Flare

Key Points

• To report the occurrence of SBRT-induced bone flare in a patient with oligometastatic prostate cancer.
• Patient underwent radical prostatectomy and SBRT for a right pubic bone metastasis.
• PSMA PET imaging was conducted before and after SBRT, specifically four weeks post-treatment.
• PSA levels were monitored to assess disease progression.
• Post-SBRT, PSMA PET showed increased uptake at the treatment site despite a significant PSA decline.
• Initial imaging indicated a 92% reduction in PSA levels, but new osseous metastases and rising PSA were later observed confirming disease progression.
• The case represents a novel observation of bone flare after SBRT treatment.

Abstract