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

Gallium-68-prostate-specific membrane antigen (⁶⁸Ga-PSMA-11) positron emission tomography/computed tomography (PET/CT) is a key imaging modality for evaluating prostate cancer. Here we report two cases of unexpected positive ⁶⁸Ga-PSMA-11 uptake in stroke lesions during prostate cancer assessment. The first patient suffered from cerebral hemorrhage in the right frontal lobe, and the second patient was diagnosed with acute cerebral infarction in the right occipital lobe. The abnormal PSMA uptake in both lesions was attributed to pathological angiogenesis and activated endothelial cells in the process of tissue repair after stroke. Since stroke may mimic brain metastasis on ⁶⁸Ga-PSMA-11 PET/CT, radiologists and nuclear medicine physicians need to integrate clinical manifestations and multimodal imaging results for accurate diagnosis, so as to prevent diagnostic errors in clinical practice.