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Hepatic Perfusion-Related Pseudolesion Mimicking Metastasis on 68 Ga-PSMA PET/CT
Kevser Oksuzoglu1, Lutfu Perktas, Hasan Onner
1Department of Nuclear Medicine, Selcuk University Faculty of Medicine, Konya, Turkey.
Abstract:
PSMA is a critical cell-surface molecule and 68 Ga-PSMA PET has become an established imaging modality that improves disease localization for newly diagnosed and recurrent prostate cancer. We report a patient with wedge-shaped increased PSMA uptake in segment VIII of the liver. MRI demonstrated no focal lesion; however, mild diffusion hyperintensity without apparent diffusion coefficient reduction and transient arterial hyperenhancement were observed. These findings were consistent with a perfusion-related pseudolesion rather than metastatic disease.
Insights
Gallium-68 PSMA PET scans can show unusual liver findings. A wedge-shaped uptake in the liver was identified as a perfusion-related pseudolesion, not prostate cancer metastasis.
Area of Science:
- Nuclear medicine
- Radiopharmaceuticals
- Prostate cancer imaging
Background:
- Prostate-specific membrane antigen (PSMA) is a key cell-surface target.
- 68Ga-PSMA PET imaging is vital for staging prostate cancer.
- Accurate localization of disease is crucial for treatment planning.
Purpose of the Study:
- To report a case of unusual PSMA uptake in the liver.
- To differentiate between true metastatic lesions and pseudolesions on imaging.
- To highlight the importance of correlating imaging findings with other modalities.
Main Methods:
- Case report of a patient with prostate cancer.
- Utilized 68Ga-PSMA PET imaging for disease localization.
- Performed Magnetic Resonance Imaging (MRI) for detailed lesion characterization.
- Analyzed imaging features including diffusion and enhancement patterns.
Main Results:
- Observed wedge-shaped increased 68Ga-PSMA uptake in liver segment VIII.
- MRI revealed no focal lesion but showed mild diffusion hyperintensity.
- Transient arterial hyperenhancement was noted on MRI.
- Findings were deemed consistent with a perfusion-related pseudolesion.
Conclusions:
- Unusual PSMA uptake patterns in the liver can represent pseudolesions.
- Careful interpretation of MRI features is essential to avoid misdiagnosis.
- Perfusion dynamics can mimic metastatic disease on PSMA PET scans.
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