Non–Prostate-Specific Membrane Antigen-Avid Metastatic Lung Nodule From Primary Prostatic Adenocarcinoma

Shetty, Deepa; Loh, Han Tong; Bui, Chuong; Mansberg, Robert; Hadjashrafi, Amirazin; Do, Viet

doi:10.1097/rlu.0000000000001329

Cited by 12 publications

(10 citation statements)

References 8 publications

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“…Neuroendocrine trans-differentiation was proven histologically in the single patient of our study who had only PSMA-negative pulmonary metastases. A case report by Shetty et al of a non-PSMA-avid PC lung metastasis suggests that an uncommon variant of the primary PC, in this case ductal adenocarcinoma, can be another cause for missing PSMA-expression [ 28 ]. However, the detection rate of the more common lymph node and bone metastases in PSMA-PET appear to be much higher.…”

Section: Discussionmentioning

confidence: 99%

68 Ga-PSMA-PET/CT for the evaluation of pulmonary metastases and opacities in patients with prostate cancer

et al. 2018

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BackgroundThe purpose of this study was to investigate the imaging properties of pulmonary metastases and benign opacities in 68Ga-PSMA positron emission tomography (PET) in patients with prostate cancer (PC).Methods68Ga-PSMA-PET/CT scans of 739 PC patients available in our database were evaluated retrospectively for lung metastases and non-solid focal pulmonary opacities. Maximum standardized uptake values (SUVmax) were assessed by two- and three-dimensional regions of interest (2D/3D ROI). Additionally CT features of the lesions, such as location, morphology and size were identified.ResultsNinety-one pulmonary metastases and fourteen opacities were identified in 34 PC patients. In total, 66 PSMA-positive (72.5%) and 25 PSMA-negative (27.5%) metastases were identified. The mean SUVmax of pulmonary opacities was 2.2±0.7 in 2D ROI and 2.4±0.8 in 3D ROI. The mean SUVmax of PSMA-positive pulmonary metastases was 4.5±2.7 in 2D ROI and in 4.7±2.9 in 3D ROI; this was significantly higher than the SUVmax of pulmonary opacities in both 2D and 3D ROI (p<0.001). The mean SUVmax of PSMA-negative metastases was 1.0±0.5 in 2D ROI and 1.0±0.4 in 3D ROI, and significantly lower than that of the pulmonary opacities (p<0.001). A significant (p<0.05) weak linear correlation between size and 3D SUVmax in lung metastases (ρSpearman=0.207) was found.ConclusionBased on the SUVmax in 68Ga-PSMA-PET alone, it was not possible to differentiate between pulmonary metastases and pulmonary opacities. The majority of lung metastases highly overexpressed PSMA, while a relevant number of metastases were PSMA-negative. Pulmonary opacities demonstrated a moderate tracer uptake, significantly lower than PSMA-positive lung metastases, yet significantly higher than PSMA-negative metastases.

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Section: Discussionmentioning

confidence: 99%

68 Ga-PSMA-PET/CT for the evaluation of pulmonary metastases and opacities in patients with prostate cancer

et al. 2018

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“…The pathology of this case was ductal prostatic carcinoma, while the CK7, and napsin A were negative, the tumor cells were reactive to AMACR and TTF-1. [6] McEwan et al . have published two cases of prostate cancer where F18-FDG shows higher uptake than PSMA.…”

Section: Resultsmentioning

confidence: 99%

Intense fluoro-2-deoxyglucose uptake in high-grade prostatic adenocarcinoma with negligible prostate-specific membrane antigen expression

et al. 2019

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While 68Gallium prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA) has demonstrated increasing utility in the evaluation of prostatic carcinoma, it is essential to be aware of false-negative findings. Further subtype analyses of prostate cancer will be helpful in the understanding of the underlying reasons. We herein present a high-grade prostate adenocarcinoma, with metastatic lesions showing high 18F-labeled fluoro-2-deoxyglucose uptake instead of 68Ga-PSMA.

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“…A-C) according to indication for dual-tracer use with subgrouping according to the ligand uptake pattern. e most common indication was for men with BCR requiring characterisation of lung nodules seen on conventional imaging (5/14 patients) [34,39,[41][42][43]. Variant histology was also common, with three cases of ductal variant and three cases of neuroendocrine differentiation, although one of these was presumed on the basis of a raised serum chromogranin A level in combination with DOTA-TOC PET avidity [34,[37][38][39][40].…”

Section: Case Reportsmentioning

confidence: 99%

Dual-Tracer Positron-Emission Tomography Using Prostate-Specific Membrane Antigen and Fluorodeoxyglucose for Staging of Prostate Cancer: A Systematic Review

McGeorge

Kwok

Jiang

et al. 2021

Advances in Urology

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PSMA PET is more accurate than conventional imaging (CT/bone scan) for staging of intermediate- or high-risk prostate cancer (PCa), but 5–10% of primary tumours have low PSMA ligand uptake. FDG PET has been used to further define disease extent in end-stage castrate-resistant PCa and may be beneficial earlier in the disease course for more accurate staging. The objective of this study was to review the available evidence for patients undergoing both FDG and PSMA PET for PCa staging at initial diagnosis and in recurrent disease. A systematic literature review was performed for studies with direct, intraindividual comparison of PSMA and FDG PET for staging of PCa. Assessment for radioligand therapy eligibility was not considered. Risk of bias was assessed. 543 citations were screened and assessed. 13 case reports, three retrospective studies, and one prospective study were included. FDG after PSMA PET improved the detection of metastases from 65% to 73% in high-risk early castration-resistant PCa with negative conventional imaging (M0). Positive FDG PET was found in 17% of men with negative PSMA PET for postprostatectomy biochemical recurrence. Gleason score ≥8 and higher PSA levels predicted FDG-avid metastases in BCR and primary staging. Variant histology (ductal and neuroendocrine) was common in case reports, resulting in PSMA-negative FDG-positive imaging for 3 patients. Dual-tracer PET for PCa may assist in characterising high-risk disease during primary staging and restaging. Further studies are required to determine the additive benefit of FDG PET and if the FDG-positive phenotype may indicate a poorer prognosis.

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Non–Prostate-Specific Membrane Antigen-Avid Metastatic Lung Nodule From Primary Prostatic Adenocarcinoma

Cited by 12 publications

References 8 publications

68 Ga-PSMA-PET/CT for the evaluation of pulmonary metastases and opacities in patients with prostate cancer

68 Ga-PSMA-PET/CT for the evaluation of pulmonary metastases and opacities in patients with prostate cancer

Intense fluoro-2-deoxyglucose uptake in high-grade prostatic adenocarcinoma with negligible prostate-specific membrane antigen expression

Dual-Tracer Positron-Emission Tomography Using Prostate-Specific Membrane Antigen and Fluorodeoxyglucose for Staging of Prostate Cancer: A Systematic Review

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