68 Ga-PSMA PET/CT Identifies "Pseudo-progression" of Bone Lesions in Prostate Cancer Observed on 68 Ga-DOTA-IBA PET/CT.

Huang, Dong; Zhang, Na; Pang, Shangjing; Gong, Jianhui; Chen, Yue · Clin Nucl Med · 2026

case_report · Level V

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Abstract

We report a case where 68 Ga-PSMA PET/CT distinguished "pseudo-progression" from progression observed on 68 Ga-DOTA-IBA PET/CT. In a 75-year-old man with metastatic castration-resistant prostate cancer (mCRPC), 68 Ga-DOTA-IBA PET/CT revealed markedly increased tracer uptake in bone metastases compared with pretreatment imaging, suggesting radiologic progression. However, 68 Ga-PSMA-11 PET/CT images demonstrated the complete metabolic response (PERCIST 1.0), revealing "pseudo-progression" of bone lesions in 68 Ga-DOTA-IBA, especially when combined with clinical symptoms, PSA, and ALP levels.

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