Schmorl’s Node

Abstract

Ga-prostate-specific membrane antigen (PSMA) ligand PET/CT is commonly believed to be prostate specific as the name itself suggests. However, PSMA-expressing nonprostatic cancers as well as benign lesions are continuously being added to the list. We reported PSMA-expressing Schmorl's node in L1 vertebra of a 74-year-old man with prostate cancer. Prostate-specific membrane antigen expression in the vertebral lesion raised a metastatic suspicion. However, on analysis of previous CT scan done 2 years before, the same lesion was observed with no significant interval change, confirming its benign nature. With more use of PSMA ligand PET/CT, more limitations and false positivities will be explored.

Schmorl Node Can Cause Increased 68Ga-FAPI Activity on PET/CT

“…The 68 Ga-FAPI uptake in Schmorl node may be related to the fibrosis associated with Schmorl node 5 . Schmorl node can also result in increased metabolic activity on 68 Ga-PSMA, 6 68 Ga-DOTATATE, 7 and 18 F-choline PET/CT 8 . In this case, 68 Ga-FAPI was superior to 18 F-FDG in the detection of lymph node metastasis, which is consistent with some previous reports 2,3 .…”

Musculoskeletal pitfalls in 68Ga-PSMA PET/CT

“…Schmorl’s nodes with PSMA uptake can represent a challenge because they mimic bone metastasis ( Figure 6 ). A lack of variation in the imaging findings in comparison with previous examinations can confirm the benign nature of the lesion ( 8 ) .…”

Hemangioma of the Ilium Simulating Bone Metastasis on 18F-PSMA-1007 PET/CT

“…1,2,5,6 There are a few case reports of 68 Ga-PSMA uptake in vertebral [7][8][9] and skull 10 hemangiomas, which may be due to PSMA expression in endothelial cells. Lowto-moderate PSMA uptake has been shown in many other benign bone lesions, including osteophyte, 11 Schmorl node, 12 fracture, 13 osteoid osteoma, 14 Paget disease, 15 fibrous dysplasia, 16 and infection. 17 Correlative anatomic imaging and PSMA PET may be especially helpful for discriminating benign bone lesion from metastatic prostate adenocarcinoma in equivocal cases.…”