68Ga-PSMA PET/CT imaging of metastatic clear cell renal cell carcinoma

Unusual Uptake of Prostate Specific Tracer 68Ga-PSMA–HBED-CC in a Benign Thyroid Nodule

“…Recently the uptake of 68 Ga-PSMA-HBED-CC has been reported in differentiated thyroid cancer by Verburg et al in nodal and pulmonary metastases in a patient with poorly differentiated thyroid carcinoma that was radioiodine negative [13]. Tracer uptake has also been shown in metastatic renal cell carcinoma by Demirci et al [14]. An early study by Chang et al showed that anti-PSMA monoclonal antibodies react strongly with neovasculature of various tumors including clear renal cell carcinoma, transitional cell carcinoma of the urinary bladder, testicular embryonal carcinoma, colonic adenocarcinoma, neuroendocrine carcinoma, glioblastoma multiforme, malignant melanoma, pancreatic duct carcinoma, non-small cell lung carcinoma, soft tissue sarcoma, breast carcinoma, and prostatic adenocarcinoma [15].…”

Prostate-Specific Membrane Antigen–Targeted Radiohalogenated PET and Therapeutic Agents for Prostate Cancer

“…The localization of a radiotracer in those cancers appears to be based on PSMA expression in tumor neovasculature (61). Clear cell renal cell carcinoma (62)(63)(64) and cancers of the thyroid (65), breast (66), and colon (67) are among the tumor types reported to have PSMA-targeted radiotracer uptake. With thoughtful, prospective trials to define the clinical utility of PSMA-targeted imaging in these cancers, PSMA-targeted imaging and therapy may prove to have broad implications in the field of oncology.…”

Molecular imaging using PSMA PET/CT versus multiparametric MRI for initial staging of prostate cancer: comparing apples with oranges?

“…As these probes are still very new, we as nuclear medicine physicians are still on the ascending slope of a steep learning curve. For instance, it has become clear that while the very high sensitivity of this tracer has often been confirmed [2,7], it is not as specific as we would wish: a considerable degree of tracer uptake is seen both in other malignancies [8,9] and in normal anatomical structures such as the coeliac ganglia which can easily be mistaken for malignant lesions [10].Whereas the clinical value of PSMA PET/CT in the imaging of (suspected) recurrent PCA is largely uncontested, this is not the case in the setting of primary staging. In the determination of lymph node status, the results published so far have been rather mixed -although it is remarkable that a study in which a nuclear medicine physician was not involved had rather poorer results [11] than studies in which nuclear medicine physicians were involved [7].…”

“…As these probes are still very new, we as nuclear medicine physicians are still on the ascending slope of a steep learning curve. For instance, it has become clear that while the very high sensitivity of this tracer has often been confirmed [2,7], it is not as specific as we would wish: a considerable degree of tracer uptake is seen both in other malignancies [8,9] and in normal anatomical structures such as the coeliac ganglia which can easily be mistaken for malignant lesions [10].…”