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Schmorl's Node: Confusion Still Persists in 68Ga-Prostate-Specific Membrane Antigen Ligand PET/CT
Manas Kumar Sahoo1, Kulbir Ahlawat2, Rajiv Yadav3
1From the Departments of Nuclear Medicine & PET-CT and.
Clinical Nuclear Medicine
|July 24, 2018
Summary
Gallium-68 prostate-specific membrane antigen (PSMA) ligand PET/CT can show false positives. Researchers found a PSMA-expressing benign lesion in a patient with prostate cancer, highlighting the need for careful interpretation.
Area of Science:
- Nuclear medicine
- Oncology
- Radiology
Background:
- Gallium-68 prostate-specific membrane antigen (PSMA) ligand PET/CT is a valuable imaging tool for prostate cancer.
- It is often considered prostate-specific, but nonprostatic cancers and benign lesions can also express PSMA.
Observation:
- A 74-year-old man with prostate cancer presented with a lesion in the L1 vertebra.
- The lesion showed uptake on Ga-PSMA PET/CT, initially raising suspicion for metastasis.
Findings:
- Previous CT scans from 2 years prior revealed the same vertebral lesion.
- The lesion showed no significant interval change, confirming its benign nature (Schmorl's node).
- This case demonstrates a false-positive finding on Ga-PSMA PET/CT due to PSMA expression in a benign lesion.
Implications:
- The findings highlight limitations of Ga-PSMA ligand PET/CT, showing it is not exclusively prostate-specific.
- Increased utilization of this imaging modality will likely reveal more instances of false positives.
- Careful correlation with prior imaging and clinical context is crucial for accurate diagnosis.