Case Reports in Oncology (Mar 2025)

Changes in Osteoblastic Bone Metastasis Detected Incidentally by Cone-Beam Computed Tomography: A Case Report

  • Uchina Hiya,
  • Masashi Endo,
  • Kohei Okada,
  • Satoru Takahashi,
  • Kazunari Ogawa,
  • Machi Nakagawa,
  • Michiko Nakamura,
  • Chiaki Shibayama,
  • Yukiko Fukuda,
  • Keiko Akahane,
  • Masahiro Kawahara,
  • Harushi Mori,
  • Katsuyuki Shirai

DOI
https://doi.org/10.1159/000545252
Journal volume & issue
Vol. 18, no. 1
pp. 493 – 499

Abstract

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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.