68Ga-PSMA PET/MR-Positive, Histopathology-Proven Prostate Cancer in a Patient With Negative Multiparametric Prostate

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Urs J Muehlematter1, Niels J Rupp2, Julian Mueller3

  • 1From the Departments of Diagnostic and Interventional Radiology.

Clinical Nuclear Medicine
|May 31, 2018
PubMed

Insights

Gallium-68 PSMA PET/MRI can detect prostate cancer (PCa) missed by standard MRI. This case highlights its potential for primary PCa detection and localization, even in men with prior negative imaging.

Area of Science:

  • Nuclear medicine and radiology
  • Prostate cancer diagnostics
  • Molecular imaging

Background:

  • Multiparametric MRI (mpMRI) is standard for detecting clinically significant prostate cancer (PCa).
  • Gallium-68 PSMA PET (Ga-PSMA) shows promise for PCa staging and restaging.
  • Emerging evidence suggests Ga-PSMA's utility in primary PCa detection and localization.

Observation:

  • A 73-year-old man presented with a lesion in the peripheral zone.
  • The lesion was positive on Ga-PSMA PET/MRI.
  • A preceding standard mpMRI of the prostate was negative for this lesion.

Findings:

  • Histopathology confirmed Gleason 4 + 4 prostate cancer.
  • The Ga-PSMA PET/MRI identified a clinically significant PCa missed by mpMRI.
  • This demonstrates the potential of Ga-PSMA PET/MRI in primary PCa detection.

Implications:

  • Ga-PSMA PET/MRI may improve the detection and localization of prostate cancer.
  • This imaging modality could enhance diagnostic accuracy, especially when mpMRI is inconclusive.
  • Further research is warranted to establish Ga-PSMA PET/MRI in the primary diagnosis of PCa.

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