Detection of Unusual Peritoneal Metastases of Prostate Cancer With 68Ga–Prostate-Specific Membrane Antigen PET/CT

Peritoneal metastasis of prostate cancer (PC) is unusual site of metastatic disease; only limited case reports are published in literature. Ga-68-prostate-specific membrane antigen (PSMA) PET/CT is recently used for detection of PC metastasis with high accuracy rates. We present a case of a 68-year-old man with disseminated peritoneal metastases and abdominal metastatic lymph nodes of PC, demonstrated in Ga-68-PSMA PET/CT with intense PSMA uptake

Detection of Unusual Peritoneal Metastases of Prostate Cancer With Ga-68-Prostate-Specific Membrane Antigen PET/CT

Peritoneal metastasis of prostate cancer (PC) is unusual site of metastatic disease; only limited case reports are published in literature. Ga-68-prostate-specific membrane antigen (PSMA) PET/CT is recently used for detection of PC metastasis with high accuracy rates. We present a case of a 68-year-old man with disseminated peritoneal metastases and abdominal metastatic lymph nodes of PC, demonstrated in Ga-68-PSMA PET/CT with intense PSMA uptake

Abdominal Splenosis Mimicking Peritoneal Metastasis in Prostate-Specific Membrane Antigen PET/CT, Confirmed With Selective Spleen SPECT/CT

Ga-68-prostate-specific membrane antigen (PSMA) PET/CT is a rapidly evolving diagnostic technique to image prostate cancer. In contrast to the name PSMA, various tissues show Ga-68-PSMA uptake in PET/CT imaging. We present a case of a 68-year-old man with prostate cancer who underwent Ga-PSMA PET/CT. Along with metastatic lymph nodes, multiple nodular lesions within the peritoneal spaces of all 4 quadrants of the abdomen showed high PSMA expression. Because of a history of splenic rupture, a Tc-99m-labeled heat-denatured erythrocyte scintigraphy and SPECT were performed. Peritoneal lesions showed high uptake, confirming widespread peritoneal splenosis

Ga-68-PSMA PET/CT and PET/MRI in high-risk prostate cancer patients

Treatment of high-risk prostate cancer (HRPCa) is challenging. Local staging and metastatic evaluation are important for the patient management. Recently, prostate-specific membrane antigen (PSMA)-based imaging modalities such as PSMA PET/CT and PET/MRI have received significant attention for detection of recurrent prostate cancer sites with elevated prostate-specific antigen levels, after therapy. Current evidence suggests that these imaging modalities may also have a role for the management of patients with HRPCa. In this review, we discuss PSMA-based imaging modalities in the management of patients with HRPCa

Detection of metastases in newly diagnosed prostate cancer by using 68Ga-PSMA PET/CT and its relationship with modified D'Amico risk classification

Purpose We aimed to investigate the diagnostic power of 68Ga-PSMA PET/CT in the detection of metastatic spread of newly diagnosed PCa, and evaluate the relationship with modified D'Amico risk classification. Methods We evaluated newly diagnosed PCa patients who underwent 68Ga-PSMA PET/CT prior to therapy. All images were interpreted retrospectively and areas of abnormally increased tracer uptake were documented according to PSMA-RADS version 1.0 system. Patients were divided into risk groups as low, intermediate, or high risk, according to a modification in D'Amico classification system as ISUP grade 3 tumors were included to high-risk group. 68Ga-PSMA PET/CT findings were compared among risk groups as well as PSA levels, clinical T stages, and ISUP grades. Results A total of 356 patients were included to the study with a median PSA level was 16.42 (1.29-7013) ng/ml and median Gleason score was 8 (range: 6-10). Of these, 13(3.7%), 54 (15.1%), and 289 (81.2%) were in the low-, intermediate-, and high-risk groups, respectively. Lymph node metastases were detected in 125 (35.1%) patients, and in 48 of them, metastasis was limited to pelvic lymph nodes (PLN). Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated as 71.4%, 100%, 95.9%, 100%, and 95.4%, respectively for the detection of PLN, based on histopathological results of 49 patients. Overall, any metastasis was detected in 47.7% of high-risk patients, while only PLN metastases were defined in 3.7% intermediate-risk patients and none of low-risk patients had any kind of metastasis. Conclusion This study revealed that 68Ga-PSMA PET/CT should be routinely used in newly diagnosed high-risk PCa patients; whereas it seems to be of limited use for intermediate-risk group and useless for the low-risk group