Incidental Finding of Colon Carcinoma Related to High Uptake in 18F-PSMA-1007 PET

Arçay, Ayça; Eiber, Matthias; Langbein, Thomas

doi:10.1097/rlu.0000000000003081

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…This includes incidental findings and studies with a large number of patients. In four (suspected) prostate cancer patients, colorectal cancer was unexpectedly found, with an SUV max varying from 7.4 to 19.6 [ 13 , 14 , 15 , 27 ]. A second study, including metastatic colorectal cancer patients, found a mean SUV max in three patients for the primary tumor of 7.9 ± 2.5 (using [ 68 Ga]Ga-PSMA-11) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Prostate-Specific Membrane Antigen Targeted Pet/CT Imaging in Patients with Colon, Gastric and Pancreatic Cancer

Vuijk

Kleiburg

Noortman

et al. 2022

Cancers

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Current imaging modalities frequently misjudge disease stage in colorectal, gastric and pancreatic cancer. As treatment decisions are dependent on disease stage, incorrect staging has serious consequences. Previous preclinical research and case reports indicate that prostate-specific membrane antigen (PSMA)-targeted PET/CT imaging might provide a solution to some of these challenges. This prospective clinical study aims to assess the feasibility of [18F]DCFPyL PET/CT imaging to target and visualize primary colon, gastric and pancreatic cancer. In this prospective clinical trial, patients with colon, gastric and pancreatic cancer were included and underwent both [18F]DCFPyL and [18F]FDG PET/CT scans prior to surgical resection or (for gastric cancer) neoadjuvant therapy. Semiquantitative analysis of immunohistochemical PSMA staining was performed on the surgical resection specimens, and the results were correlated to imaging parameters. The results of this study demonstrate detection of the primary tumor by [18F]DCFPyL PET/CT in 7 out of 10 patients with colon, gastric and pancreatic cancer, with a mean tumor-to-blood pool ratio (TBR) of 3.3 and mean SUVmax of 3.6. However, due to the high surrounding uptake, visual distinction of these tumors was difficult, and the SUVmax and TBR on [18F]FDG PET/CT were significantly higher than on [18F]DCFPyL PET/CT. In addition, no correlation between PSMA expression in the resection specimen and SUVmax on [18F]DCFPyL PET/CT was found. In conclusion, the detection of several gastrointestinal cancers using [18F]DCFPyL PET/CT is feasible. However, low tumor expression and high uptake physiologically in organs/background hamper the clear distinction of the tumor. As a result, [18F]FDG PET/CT was superior in detecting colon, gastric and pancreatic cancers.

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Section: Discussionmentioning

confidence: 99%

Prostate-Specific Membrane Antigen Targeted Pet/CT Imaging in Patients with Colon, Gastric and Pancreatic Cancer

Vuijk

Kleiburg

Noortman

et al. 2022

Cancers

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“…This is also relevant for exploring the potential use of PSMA for diagnosis and theranostics of different neoplasms. In fact, an increasing number of manuscripts have discussed the possible use of radiolabeled PSMA imaging or treatment of colorectal cancer [3,7,8], brain tumors [4,9,10], women's and men's breast cancer [11,12], head and neck cancer [5] and other solid tumors. Few isolated reports have also documented the uptake of radiolabeled PSMA in lymphomas [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Head-to-head comparison between 68Ga-PSMA and 18F-FDG-PET/CT in lymphomas: a preliminary analysis

Souza

Tobar

Frasson

et al. 2021

Nuclear Medicine Communications

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Purpose Isolated case reports mention the uptake of radiolabeled PSMA in lymphoma. However, it is not clear if the intensity of 68Ga-PSMA expression varies among different histological subtypes or if it correlates with 18F-FDG uptake. This study compared both tracers in patients with diverse lymphoma subtypes. Methods Ten patients with biopsy-proven-lymphoma underwent 18F-FDG and 68Ga-PSMA-PET/CT (maximum time interval: 6 days). Lymphoma subtypes included Hodgkin’s lymphoma (HL, three patients) and aggressive and indolent non-Hodgkin’s lymphoma (NHL, seven patients). The intensity of PSMA uptake was classified visually as low, intermediate, or high, using blood pool, liver and parotid gland uptake as references. Maximum standardized-uptake value (SUVmax) of each affected site was measured in both sets of images. Results FDG detected 59/59 involved sites in 10 patients and PSMA 47/59 sites in nine patients. PSMA uptake was generally low, regardless of the intensity of FDG uptake, but it was classified as intermediate in two patients. The median SUVmax varied from 2.0 (2.0–8.2) to 30.9 for FDG and from 1.7 (1.7–1.7) to 4.4 for PSMA, P < 0.0001. The primary lesion of one patient had a marked intralesional mismatch uptake pattern of the tracers, with areas of higher PSMA expression than FDG uptake, and vice-versa. A brain lesion was more easily identified with PSMA than with FDG images. Conclusion HL and several NHL subtypes may present PSMA uptake. The intensity of PSMA expression is generally lower than that of FDG uptake and seems to present less variation among the different histological subtypes of lymphomas.

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“…6 There are multiple case reports showing PSMA uptake in benign tumors and nonprostate malignancies. [7][8][9][10][11][12][13] Desmoid-type fibromatosis, also known as aggressive fibromatosis, musculoaponeurotic fibromatosis, and desmoid tumor, is a rare mesenchymal neoplasm associated with high rates of local recurrence but lacks the potential to metastasize. 14 The treatment consensus has changed over the past decade from surgery to observation, and hence imaging plays an important role in follow-up.…”

mentioning

confidence: 99%

“…PSMA is also expressed in several other malignancies including breast, lung, colorectal, bladder, renal, pancreatic, and primary brain tumors 6. There are multiple case reports showing PSMA uptake in benign tumors and nonprostate malignancies [7][8][9][10][11][12][13]. Desmoid-type fibromatosis, also known as aggressive fibromatosis, musculoaponeurotic fibromatosis, and desmoid tumor, is a rare mesenchymal neoplasm associated with high rates of local recurrence but lacks the potential to metastasize 14.…”

mentioning

confidence: 99%

PSMA-Avid Desmoid Tumor of the Abdominal Wall on 18F-Piflufolastat PET/CT

Bommekal,

Flynt,

Tewari

et al. 2024

Clin Nucl Med

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Prostate-specific membrane antigen (PSMA) PET/CT is widely used in the evaluation of suspected metastasis for initial definitive therapy and suspected recurrence of prostate cancer. We outline a case report of a 62-year-old man with history of prostate cancer treated with surgery, salvage radiation, and hormonal therapy presenting with rising PSA levels. There was incidental detection of a PSMA-avid subcutaneous abdominal wall mass on PSMA PET/CT study, which was consistent with desmoid fibromatosis on an ultrasound-guided biopsy.

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Incidental Finding of Colon Carcinoma Related to High Uptake in 18F-PSMA-1007 PET

Cited by 4 publications

References 10 publications

Prostate-Specific Membrane Antigen Targeted Pet/CT Imaging in Patients with Colon, Gastric and Pancreatic Cancer

Prostate-Specific Membrane Antigen Targeted Pet/CT Imaging in Patients with Colon, Gastric and Pancreatic Cancer

Head-to-head comparison between 68Ga-PSMA and 18F-FDG-PET/CT in lymphomas: a preliminary analysis

PSMA-Avid Desmoid Tumor of the Abdominal Wall on 18F-Piflufolastat PET/CT

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