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68Ga-Prostate-Specific Membrane Antigen Focal Pulmonary Activity With No Corresponding CT Abnormality
Arun Sasikumar1, Sam Thampan2, Nivya Thomas1
1From the St Gregorios International Cancer Care Centre.
Clinical Nuclear Medicine
|October 8, 2020
Summary
A case study highlights focal tracer uptake in the lung during prostate-specific membrane antigen PET/CT scans, potentially due to iatrogenic pulmonary microembolism. This finding, without CT abnormalities, suggests a new diagnostic consideration in PET imaging.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Prostate-specific membrane antigen (PSMA) PET/CT is crucial for staging prostate cancer.
- Focal lung uptake on PET/CT without CT correlation can be challenging to interpret.
- Previous studies proposed iatrogenic pulmonary microembolism or infection/inflammation for 18F-FDG uptake.
Observation:
- A case of 68Ga-PSMA PET/CT demonstrated focal tracer concentration in the lung.
- The corresponding CT scan showed no pulmonary abnormalities.
- No signs of lung infection or inflammation were present in the patient.
Findings:
- The focal 68Ga-PSMA uptake in the lung without CT lesions is a novel observation.
- Iatrogenic pulmonary microembolism is proposed as the most plausible cause.
- This mechanism is logically extendable from similar findings with 18F-FDG PET/CT.
Implications:
- This case expands the understanding of unexpected findings in PSMA PET/CT.
- It suggests considering iatrogenic microembolism in the differential diagnosis of focal lung uptake.
- Further research may clarify the incidence and significance of this phenomenon in PSMA imaging.
