Fatal Intracranial Hemorrhage Due to Thrombocytopenia in a Patient with Castration-Resistant Prostate Cancer Showing Extensive Bone Uptake of Injected 223Ra Dichloride

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A 64-year-old man with castration-resistant prostate cancer received 223Ra injection to treat bone metastases. The patient underwent a 223Ra SPECT scan after the first 223Ra injection in which there was increased uptake all over the spine. Spine-to-background activity ratio in the patient was approximately three times greater than normal spine-to-background activity ratios in 223Ra SPECT obtained from the other patients. Eight days after the fifth injection, the patient exhibited a very poor neurologic examination and died of intracranial hemorrhage due to severe thrombocytopenia (platelet counts, 23,000/mm3). The extensive radiation to the spine may have enhanced myelophthisic process in this case.

Original languageEnglish
Pages (from-to)546-547
Number of pages2
JournalClinical Nuclear Medicine
Volume43
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

Fingerprint

Intracranial Hemorrhages
Castration
Thrombocytopenia
Prostatic Neoplasms
Spine
Bone and Bones
Single-Photon Emission-Computed Tomography
Injections
Neurologic Examination
Platelet Count
Radiation
Neoplasm Metastasis

Keywords

  • Ra
  • intracranial hemorrhage
  • myelotoxicity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{33cea00b885545d981953497ed88f659,
title = "Fatal Intracranial Hemorrhage Due to Thrombocytopenia in a Patient with Castration-Resistant Prostate Cancer Showing Extensive Bone Uptake of Injected 223Ra Dichloride",
abstract = "A 64-year-old man with castration-resistant prostate cancer received 223Ra injection to treat bone metastases. The patient underwent a 223Ra SPECT scan after the first 223Ra injection in which there was increased uptake all over the spine. Spine-to-background activity ratio in the patient was approximately three times greater than normal spine-to-background activity ratios in 223Ra SPECT obtained from the other patients. Eight days after the fifth injection, the patient exhibited a very poor neurologic examination and died of intracranial hemorrhage due to severe thrombocytopenia (platelet counts, 23,000/mm3). The extensive radiation to the spine may have enhanced myelophthisic process in this case.",
keywords = "Ra, intracranial hemorrhage, myelotoxicity",
author = "Tadaki Nakahara and Yoshiki Owaki and Takeo Kosaka and Junichi Fukada and Akira Ichimura and Masahiro Jinzaki",
year = "2018",
month = "7",
day = "1",
doi = "10.1097/RLU.0000000000002117",
language = "English",
volume = "43",
pages = "546--547",
journal = "Clinical Nuclear Medicine",
issn = "0363-9762",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Fatal Intracranial Hemorrhage Due to Thrombocytopenia in a Patient with Castration-Resistant Prostate Cancer Showing Extensive Bone Uptake of Injected 223Ra Dichloride

AU - Nakahara, Tadaki

AU - Owaki, Yoshiki

AU - Kosaka, Takeo

AU - Fukada, Junichi

AU - Ichimura, Akira

AU - Jinzaki, Masahiro

PY - 2018/7/1

Y1 - 2018/7/1

N2 - A 64-year-old man with castration-resistant prostate cancer received 223Ra injection to treat bone metastases. The patient underwent a 223Ra SPECT scan after the first 223Ra injection in which there was increased uptake all over the spine. Spine-to-background activity ratio in the patient was approximately three times greater than normal spine-to-background activity ratios in 223Ra SPECT obtained from the other patients. Eight days after the fifth injection, the patient exhibited a very poor neurologic examination and died of intracranial hemorrhage due to severe thrombocytopenia (platelet counts, 23,000/mm3). The extensive radiation to the spine may have enhanced myelophthisic process in this case.

AB - A 64-year-old man with castration-resistant prostate cancer received 223Ra injection to treat bone metastases. The patient underwent a 223Ra SPECT scan after the first 223Ra injection in which there was increased uptake all over the spine. Spine-to-background activity ratio in the patient was approximately three times greater than normal spine-to-background activity ratios in 223Ra SPECT obtained from the other patients. Eight days after the fifth injection, the patient exhibited a very poor neurologic examination and died of intracranial hemorrhage due to severe thrombocytopenia (platelet counts, 23,000/mm3). The extensive radiation to the spine may have enhanced myelophthisic process in this case.

KW - Ra

KW - intracranial hemorrhage

KW - myelotoxicity

UR - http://www.scopus.com/inward/record.url?scp=85048713493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048713493&partnerID=8YFLogxK

U2 - 10.1097/RLU.0000000000002117

DO - 10.1097/RLU.0000000000002117

M3 - Article

VL - 43

SP - 546

EP - 547

JO - Clinical Nuclear Medicine

JF - Clinical Nuclear Medicine

SN - 0363-9762

IS - 7

ER -