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Espondilodiscitis: Una trampa de falsos positivos en la gammagrafía con 68Ga-PSMA
Amin Saber Tanha1, Farid Jafari Zarrin Ghabaei1, Hamidreza Ghorbani2,3
1Nuclear Medicine Research Center, Mashhad University of Medical Sciences.
Clinical nuclear medicine
|February 2, 2026
Resumen
La imagenología del antígeno prostático específico de membrana (PSMA) puede presentar falsos positivos. La espondilodiscitis simuló la diseminación del cáncer de próstata en estudios de PSMA, lo que resalta la necesidad de correlación clínica para evitar diagnósticos erróneos.
Área de la Ciencia:
- Medicina Nuclear
- Radiología
- Oncología
Sus antecedentes:
- El antígeno prostático específico (PSA) elevado y los síntomas urinarios pueden indicar cáncer de próstata.
- La gammagrafía con PSMA de galio-68 (68Ga) es una modalidad de imagen clave para la estadificación del cáncer de próstata.
- Es crucial distinguir la enfermedad verdadera de los artefactos o afecciones benignas para un diagnóstico preciso.
Objetivo del estudio:
- Evaluar la utilidad diagnóstica de la gammagrafía con 68Ga-PSMA en un paciente con sospecha de cáncer de próstata.
- Investigar la posibilidad de hallazgos falsos positivos en la imagenología de PSMA.
- Enfatizar la importancia de integrar la imagenología con datos clínicos y de laboratorio.
Principales métodos:
- Un paciente varón de 65 años con PSA elevado y síntomas urinarios se sometió a una PET/CT con 68Ga-PSMA.
- Se correlacionaron el historial clínico, los marcadores inflamatorios y los hallazgos de la TC con los patrones de captación de PSMA.
- Se evaluó la puntuación PRIMARIA según la distribución de la captación de PSMA.
Principales resultados:
- El estudio reveló una mayor captación de PSMA en las placas terminales vertebrales, consistente con espondilodiscitis.
- Se observó una captación simétrica de PSMA en la próstata, que se correlacionó con una puntuación PRIMARIA de 2.
- La espondilodiscitis se confirmó mediante datos clínicos y de laboratorio.
Conclusiones:
- La espondilodiscitis puede presentarse como un hallazgo falso positivo en la gammagrafía con 68Ga-PSMA.
- La interpretación precisa de la PET/CT con PSMA requiere la correlación con la presentación clínica y los marcadores de laboratorio.
- Es esencial una evaluación cuidadosa para prevenir el diagnóstico erróneo de progresión del cáncer de próstata.
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