Lumbar Osteophyte Avid on 68Ga-Prostate-Specific Membrane Antigen PET/CT

Area of Science:

• Nuclear medicine
• Oncology
• Radiology

Background:

• Prostate-specific membrane antigen (PSMA) PET/CT is a key imaging modality for staging high-risk prostate cancer.
• Accurate staging is crucial for treatment planning and prognosis in prostate cancer patients.
• Benign findings can sometimes mimic malignant uptake on PSMA PET/CT, posing interpretation challenges.

Observation:

• A 75-year-old man with high-risk prostate cancer underwent Ga-PSMA PET/CT for staging.
• Intense Ga-PSMA uptake was observed in a lumbar osteophyte at L2/L3.
• Other spinal osteophytes did not show significant Ga-PSMA uptake.

Findings:

• MRI confirmed a benign Modic type 1 lesion in the L3 vertebra.
• Despite high Ga-PSMA uptake, MRI revealed no signs of malignancy in the osteophyte.
• The osteophyte demonstrated a false-positive Ga-PSMA uptake pattern.

Implications:

• Osteophytes should be recognized as potential sites of benign Ga-PSMA uptake.
• Awareness of such pitfalls can improve the accuracy of prostate cancer staging interpretation.
• This case expands the differential diagnosis for benign findings on Ga-PSMA PET/CT.