68Ga-Prostate-Specific Membrane Antigen Uptake in Dissecting Abdominal Aortic Aneurysm

Area of Science:

• Nuclear medicine
• Oncology
• Vascular imaging

Background:

• Prostate adenocarcinoma management involves monitoring for recurrence using imaging.
• Gallium-68 prostate-specific membrane antigen (PSMA-HBED-CC) PET/CT is utilized for detecting prostate cancer.
• Aortic aneurysms require careful monitoring for complications like dissection and thrombus formation.

Observation:

• A patient with rising prostate-specific antigen post-treatment demonstrated local recurrence and nodal metastases on PSMA-HBED-CC PET/CT.
• An incidental finding of PSMA avidity was observed in the anterior wall of an infrarenal aortic aneurysm.
• The aneurysm exhibited features consistent with an enlarging dissecting thrombus.

Findings:

• PSMA-HBED-CC PET/CT confirmed local prostatic recurrence and nodal metastases.
• A PSMA-avid focus within the aortic aneurysm suggests potential inflammatory activity or neovascularization.
• Increased PSMA avidity was also noted in atherosclerotic lesions, potentially indicating plaque instability.

Implications:

• PSMA-HBED-CC PET/CT can identify prostate cancer recurrence and metastases.
• The incidental PSMA avidity in the aortic aneurysm warrants further investigation into its significance.
• PSMA avidity in atherosclerosis may serve as a biomarker for active plaque instability, requiring further research.