Changes in Osteoblastic Bone Metastasis Detected Incidentally by Cone-Beam Computed Tomography: A Case Report
Uchina Hiya1, Masashi Endo1, Kohei Okada1,2
1Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan.
Introduction:
Although cone-beam computed tomography (CBCT) is essential for tumor positioning in image-guided radiotherapy, its diagnostic application is limited by low image quality. This report highlights a case where CBCT unexpectedly detected osteoblastic bone metastasis during radiotherapy for prostate cancer.
Case Presentation:
A 65-year-old man with recurrent prostate cancer underwent postoperative intensity-modulated radiotherapy of 66 Gy in 33 fractions. Two months after treatment, an increase in prostate-specific antigen (PSA) levels led us to perform imaging that revealed a new osteoblastic metastasis in the left acetabulum. A retrospective review of the CBCT scans obtained during radiotherapy showed progressive osteoblastic changes that were not visible on pre-treatment imaging.
Conclusion:
The progressive changes in osteoblastic bone metastases on CBCT highlight its potential usefulness in daily monitoring and evaluation during radiotherapy.
