Phenotypic appearances of prostate utilizing PET-MRI and PET-CT with 68Ga-PSMA, radiolabelled choline and 68Ga-DOTATATE

Abstract

The objective of this study was to highlight the role of multimodality imaging and present the differential diagnosis of abnormal tracer accumulation in the prostate and periprostatic tissue. Our departments have performed molecular imaging of the prostate utilizing PET-CT and PET-MRI with a range of biomarkers including F-FDG, radiolabelled choline, Ga-DOTATATE PET-CT and Ga-PSMA images. We retrospectively reviewed the varying appearances of the prostate gland in different diseases and incidental findings in periprostatic region. The differential diagnosis of pathologies related to prostate and periprostatic tissue on multimodality imaging includes malakoplakia, rhabdomyosarcoma, lymphoma, prostate cancer, neuroendocrine tumours, uchida changes, rectoprostatic fistula, synchronous malignancies, lymphocoele and schwanoma. There exists a wide differential for abnormal tracer accumulation in the prostate gland. As a radiologist and nuclear medicine physician, it is important to be aware of range of prostatic and periprostatic pathologies.

Pitfall of 18F-PSMA PyL PET/CT Imaging of a Displaced Urinary Bladder as Recurrent Prostate Malignancy

“…Postprostatectomy lymphocele is not an uncommon complication of surgical treatment with rates of occurrence likely varying based on surgical technique with varying approaches to management depending on clinical presentation. [4][5][6] Interestingly, there is mention of lymphocele in the PSMA-1007 literature 7 with one article suggesting low level PSMA-1007 uptake 6 ; however, we did not find any similar case reports with regards to PSMA DCFPyL, specifically a case demonstrating possible postprostatectomy lymphocele being mistaken for urinary bladder.…”