Mads Ryø Jochumsen

Subcutaneous Lobular Capillary Hemangioma on 68Ga-PSMA PET/CT.

We present a case of a subcutaneous process in the abdominal wall with high prostate-specific membrane antigen (PSMA) activity on Ga-PSMA PET/CT. Histology demonstrated a benign lobular capillary hemangioma with a high vascular density, with highly PSMA-positive endothelial cells. It is well known that PSMA is expressed in different tissue, including neovasculature in various malignant tumors, and the knowledge is rapidly evolving as new discoveries appear.

Metastases From Colorectal Cancer Avid on 68Ga-PSMA PET/CT

Ga-PSMA PET/CT is currently used for detection of prostate cancer including metastases, even at low prostate-specific antigen values. A grown number of reports have shown increased uptake of PSMA in neovessels of nonprostatic malignancies including lung cancer, and recently a case report has demonstrated increased PSMA uptake in colorectal adenocarcinoma. In this case report, we demonstrate increased Ga-PMSA uptake on PET/CT in metastases from previously treated colon adenocarcinoma, and it illustrates the importance of histology of suspicious lesions on Ga-PSMA PET/CT.

Benign Traumatic Rib Fracture: A Potential Pitfall on 68Ga–Prostate-Specific Membrane Antigen PET/CT for Prostate Cancer

Two, respectively, 72- and 76-year-old men with recently diagnosed high-risk prostate cancer were referred for primary staging with Ga-prostate-specific membrane antigen (PSMA) PET/CT. In both patients, the PET scans revealed increased Ga-PSMA uptake in, respectively, 3 and 4 rib fractures, characteristically placed as pearls on a string. These cases illustrate important pitfalls when reporting PSMA PET.

68Ga-PSMA Avid Primary Adenocarcinoma of the Lung With Complementary Low 18F-FDG Uptake

Ga-PSMA PET/CT scan on a 70-year-old man with recently diagnosed prostate cancer revealed a spiculating nodule in the apex of the left lung with intense Ga-PSMA uptake. The nodule had no pathological F-FDG uptake and turned out to be a primary adenocarcinoma of the lung. Cases with complementary pattern of uptake in F-FDG and Ga-PSMA in metastatic clear cell renal carcinoma and in well-differentiated hepatocellular carcinoma have previously been reported; however, this case illustrates that this unusual pattern can also be present in primary lung cancer.

Prospective comparative study ofF-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer

Abstract Aim: To compare 18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and 99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment. Material and methods: Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1–3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses. Results: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar’s test, pu2009=u2009.18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen’s kappa 0.53, 95% confidence interval 0.26–0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, nu2009=u200928; 88% for NGH, nu2009=u200916, and 80% for chemotherapy, nu2009=u200920). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy. Conclusion: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.

Intense 68Ga-PSMA Uptake in Diverticulum of the Sigmoid Colon

We present a case of a diverticulum of the sigmoid colon with intense prostate-specific membrane antigen (PSMA) activity on Ga-PSMA PET/CT. CT scan and colonoscopy showed no signs of inflammation or malignancy. This case presents an addition to the collection of benign pitfalls when reporting PSMA PET/CT; however, a Ga-PSMA up-taking focus in the colon should always cause further examination, as malignant etiology must be ruled out.