99m Tc-PSMA Scintigraphy in Splenic Hemangioma

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Prostate adenocarcinoma staging is crucial for treatment planning.
• 99mTc-PSMA scintigraphy is a key imaging modality for prostate cancer.
• Splenic lesions can sometimes present diagnostic challenges.

Purpose of the Study:

• To report a case of false-positive 99mTc-PSMA uptake in a splenic hemangioma.
• To emphasize the importance of considering benign splenic pathology in PSMA imaging interpretation.

Main Methods:

• A 67-year-old man with prostate adenocarcinoma underwent 99mTc-PSMA scintigraphy for staging.
• Analysis of scintigraphy findings, including localized prostate uptake and splenic lesion uptake.
• Histopathological confirmation of the splenic lesion.

Main Results:

• 99mTc-PSMA scintigraphy showed localized uptake in the prostate (miTNM: T2mN0M0, PRIMARY score: 5).
• Increased PSMA uptake was observed in a hypo-dense splenic lesion (PSMA-RADS-3C).
• The splenic lesion was confirmed as a hemangioma, representing a false-positive finding.

Conclusions:

• Splenic hemangiomas can cause false-positive results on 99mTc-PSMA scintigraphy.
• Radiologists and clinicians should be aware of this potential pitfall in prostate cancer staging.
• Careful correlation with imaging characteristics and clinical context is essential for accurate interpretation.