Potential Pitfall in the Interpretation of Ganglioneuronal Uptake of 18F-PSMA-1007 PET/CT Scans Performed With a High Spatial Resolution Digital PET Scanner

Abstract

A 69-year-old man with biochemical recurrence of prostate cancer after radical prostatectomy 5 years previously and subsequent salvage radiotherapy to the prostate bed and pelvic nodes underwent PET/CT on a Siemens mCT Flow PET and a second PET/CT 10 months later on a Siemens Vision 600 Digital PET. In addition to a suspicious left hilar lymph node, the new high-resolution PET showed increased visualization and avidity of physiologic uptake in paraspinal and presacral sympathetic ganglia. Caution should be undertaken when interpreting PET/CTs performed on high-resolution digital scanners to avoid mistaking ganglia uptake for metastatic disease.

Increased 18F-PSMA and 18F-FDG Uptake in Lipomatous Hypertrophy of the Interatrial Septum

“…16 There is no evidence of increased 18 F-FDG uptake in other brown adipose tissue in our patient, and this theory has also been questioned by some authors, suggesting inflammation or other unknown mechanism of increased 18 F-FDG uptake. 17 To the best of our knowledge, we report the first case of repeated markedly increased 18 F-PSMA-1007 uptake in LHIS, another potential site of unspecific 18 F-PSMA-1007 uptake not related to prostate tissue, besides the well-known mostly benign unspecific bone uptake, 18 various benign disorders, [19][20][21][22][23][24][25][26][27][28] physiological uptake in different organs, 29 and uptake in other lipomatous benign or malignant tumors. 30,31 Although the exact uptake mechanism of 18 F-PSMA-1007 and 18 F-FDG in LHIS remains unclear, accurate analysis of the CT should be performed in cases of increased tracer uptake in the interatrial septum to rule out metastatic disease or lipomatous malignancies and confirm the diagnosis of an LHIS.…”