Effective Prostate-Specific Membrane Antigen–Based 18F-DCFPyL–Guided Cryoablation of a Single Positive Site in a Patient Believed to Be More Metastatic on 11C-Choline PET/CT

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PET/CT-guided interventions using specific radiotracers are promising for detecting avid lesions not well visualized with other imaging methods. A 72-year-old man who initially presented with prostate cancer Gleason 5 + 4 (prostate-specific antigen [PSA] = 7.9 ng/mL) underwent radical prostatectomy and node dissection. Three years after radiation, a rising PSA was observed over 6 months with PSA level reaching 1.08 ng/mL. He was evaluated with prostate-specific membrane antigen–based (PSMA) 18F-DCFPyL PET/CT, conventional CT, 18F-FDG PET/CT, and 11C-choline PET/CT. The PSMA 18F-DCFPyL PET/CT successfully targeted oligometastatic prostate cancer, whereas the other imaging studies were not correct in assessing disease extent.

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