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Persistent PSMA Expression at a Subdural Hematoma Following Middle Meningeal Artery Embolization
Mudassir Mumtaz1, Randy Yeh, Sampanna Rayamajhi
1Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai West, New York, NY.
Clinical Nuclear Medicine
|February 12, 2026
Summary
18F-DCFPyL PET/CT imaging revealed unexpected prostate-specific membrane antigen (PSMA) uptake in a chronic subdural hematoma (cSDH). This finding, potentially linked to inflammation and neoangiogenesis, is crucial for accurate diagnosis in prostate cancer patients.
Area of Science:
- Nuclear medicine
- Oncology
- Neurology
Background:
- Active surveillance for low-risk prostate cancer is common.
- Rising prostate-specific antigen (PSA) levels can indicate disease progression.
- Chronic subdural hematomas (cSDH) are collections of blood under the dura mater.
Purpose of the Study:
- To report an unusual finding of 18F-DCFPyL PET/CT uptake in a cSDH.
- To investigate the potential cause of PSMA expression in cSDH.
- To emphasize the importance of recognizing non-malignant uptake on PSMA PET/CT.
Main Methods:
- A case study of an 82-year-old man with prostate cancer and cSDH.
- Utilized 18F-DCFPyL PET/CT imaging for rising PSA.
- Correlated imaging findings with patient history, including middle meningeal artery embolization.
Main Results:
- 18F-DCFPyL PET/CT showed interval progression of prostate cancer.
- Intracranial uptake was observed along the right frontoparietal convexity, corresponding to a known cSDH.
- PSMA expression in cSDH was noted, suggesting inflammation-driven neoangiogenesis.
Conclusions:
- PSMA expression can occur in cSDH, mimicking metastatic disease.
- Recognition of this phenomenon is vital to prevent misinterpretation.
- This finding may offer new insights into cSDH pathophysiology and treatment.
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