Meningioma uptake of ⁶⁸Gallium-PSMA-11 as a pitfall on positron emission tomography/computer tomography

Abstract

Prostate cancer is the most common malignancy in men with high incidence of recurrence following treatment. Biochemical recurrence, as indicated by rising PSA levels following successful treatment of the primary disease, is a frequent encounter in routine clinical practice. 68Gallium-PSMA positron emission tomography/computer tomography has been widely accepted as the modality of choice with the highest impact in management of this group of patients. Pitfalls of this diagnostic technique stem from the diversity of histological entities, other than prostate tumour cells, which can demonstrate increased uptake of the radiotracer. We present a case of intracranial uptake of PSMA by meningioma in a patient with BCR, as a pitfall in imaging of prostate cancer. Knowledge of normal distribution of the tracer is of utmost importance when reading positron emission tomography/computer tomography imaging especially given the relative novelty of usage of 68Gallium-PSMA.

Prostate-Specific Membrane Antigen as Target for Neuroimaging of Central Nervous System Tumors

“…Gupta et al also reported a parietal lobe meningioma that demonstrated avid 68 Ga-PSMA uptake, and diagnosis was supported by MRI [75]. Courtney et al reported a patient with a history of prostate cancer who demonstrated 68 Ga-PSMA uptake in the left frontal lobe, confirmed as a preexisting meningioma [76]. Finally, Junqueira et al reported avid 68 Ga-PSMA uptake (SUV max 12.1) in an MRI-detected lesion, suggestive of an intraventricular meningioma of a patient with history of prostate cancer [77].…”

Prostate-Specific Membrane Antigen Expression in Meningioma: A Promising Theranostic Target

“…These findings were confirmed by multiple studies that reported expression of PSMA in many solid tumors, primary gliomas, and brain metastases ( 6–10 ). In addition, case reports are becoming more frequent in which maintenance imaging of patients with a known history of prostate cancer with 68GA PSMA-11 has led to the incidental finding of PSMA-avid meningiomas ( 4 , 21 ).…”