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68Ga-PSMA-11 uptake in tracheal mucus plug - a potential pitfall
Kunal Ramesh Chandekar1, Apurva Sood1, Rajender Kumar1
1Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Nuclear Medicine and Molecular Imaging
|February 21, 2022
Summary
Prostate-specific membrane antigen (PSMA) PET/CT scans can show uptake in benign conditions. This case details PSMA ligand uptake in a tracheal mucus plug, a potential false-positive in prostate cancer imaging.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiology
Background:
- Prostate-specific membrane antigen (PSMA) PET/CT is a key imaging tool for prostate cancer (PCa).
- PSMA radioligand uptake has been observed in various benign tumors and lesions, posing diagnostic challenges.
Purpose of the Study:
- To report an unusual case of PSMA ligand uptake in the tracheal lumen in a patient with prostate cancer.
- To highlight the potential for false-positive findings in PSMA PET/CT due to benign uptake.
Main Methods:
- A case of prostate cancer was investigated using 68Ga-PSMA-11 PET/CT.
- A subsequent 18F-PSMA-1007 PET/CT was performed for comparison and further evaluation.
Main Results:
- 68Ga-PSMA-11 PET/CT showed unexpected radiotracer uptake within the tracheal lumen.
- 18F-PSMA-1007 PET/CT on a later date revealed no abnormal uptake or lesion in the trachea.
- The uptake was attributed to a tracheal mucus plug, representing non-prostatic benign PSMA ligand uptake.
Conclusions:
- This case underscores the importance of recognizing benign PSMA uptake in the trachea.
- Tracheal mucus plugs can mimic false-positive findings on PSMA PET/CT, requiring careful interpretation.
- Differentiating benign uptake from true malignancy is crucial for accurate prostate cancer staging and management.
