Two cases of positive ⁶⁸Ga-PSMA-11 PET imaging in stroke

Area of Science:

• Nuclear Medicine
• Radiology
• Oncology

Background:

• Gallium-68-prostate-specific membrane antigen (⁶⁸Ga-PSMA-11) PET/CT is crucial for prostate cancer staging and monitoring.
• PSMA expression is typically associated with prostate cancer cells.

Purpose of the Study:

• To report and analyze two cases of unexpected ⁶⁸Ga-PSMA-11 uptake in stroke lesions.
• To emphasize the importance of differentiating stroke lesions from brain metastases on ⁶⁸Ga-PSMA-11 PET/CT.

Main Methods:

• Case report of two patients undergoing ⁶⁸Ga-PSMA-11 PET/CT for prostate cancer evaluation.
• Analysis of imaging findings in patients with confirmed stroke (cerebral hemorrhage and infarction).

Main Results:

• Unexpected positive ⁶⁸Ga-PSMA-11 uptake was observed in the stroke lesions of both patients.
• Abnormal uptake was attributed to pathological angiogenesis and activated endothelial cells during stroke tissue repair.

Conclusions:

• Stroke lesions can exhibit abnormal ⁶⁸Ga-PSMA-11 uptake, potentially mimicking brain metastases.
• Radiologists and nuclear medicine physicians must integrate clinical data and multimodal imaging to ensure accurate diagnosis and prevent misdiagnosis.