Subacute Stroke Mimicking Cerebral Metastasis in 68Ga-PSMA-HBED-CC PET/CT

Noto, Benjamin; Vrachimis, Alexis; Schäfers, Michael; Stegger, Lars; Rahbar, Kambiz

doi:10.1097/rlu.0000000000001291

Cited by 56 publications

(35 citation statements)

References 10 publications

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“…Some of the data from 76 patients in the present study have been analysed in previous studies on different topics [18–20, 24–26]. Patients without recurrent disease and patients who were referred for PSMA radioligand therapy were excluded from this study.…”

Section: Methodsmentioning

confidence: 99%

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Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients

Afshar‐Oromieh

Holland‐Letz

Giesel

et al. 2017

Eur J Nucl Med Mol Imaging

451

318

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PurposeSince the clinical introduction of 68Ga-PSMA-11 PET/CT, this imaging method has rapidly spread and is now regarded as a significant step forward in the diagnosis of recurrent prostate cancer (PCa). The aim of this study was to analyse the influence of several variables with possible influence on PSMA ligand uptake in a large cohort.MethodsWe performed a retrospective analysis of 1007 consecutive patients who were scanned with 68Ga-PSMA-11 PET/CT (1 h after injection) from January 2014 to January 2017 to detect recurrent disease. Patients with untreated primary PCa or patients referred for PSMA radioligand therapy were excluded. The possible effects of different variables including PSA level and PSA doubling time (PSADT), PSA velocity (PSAVel), Gleason score (GSC, including separate analysis of GSC 7a and 7b), ongoing androgen deprivation therapy (ADT), patient age and amount of injected activity were evaluated.ResultsIn 79.5% of patients at least one lesion with characteristics suggestive of recurrent PCa was detected. A pathological (positive) PET/CT scan was associated with PSA level and ADT. GSC, amount of injected activity, patient age, PSADT and PSAVel were not associated with a positive PET/CT scan in multivariate analysis.Conclusion 68Ga-PSMA-11 PET/CT detects tumour lesions in a high percentage of patients with recurrent PCa. Tumour detection is clearly associated with PSA level and ADT. Only a tendency for an association without statistical significance was found between higher GSC and a higher probability of a pathological PET/CT scan. No associations were found between a pathological 68Ga-PSMA-11 PET/CT scan and patient age, amount of injected activity, PSADT or PSAVel. Electronic supplementary materialThe online version of this article (doi:10.1007/s00259-017-3711-7) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

“…Since the late 1990s, it has been known that the neovasculature of many solid tumours also expresses PSMA [5]. Recently, there have been many reports of the uptake of PSMA ligands in various nonprostate tissues [6–18]. …”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients

Afshar‐Oromieh

Holland‐Letz

Giesel

et al. 2017

Eur J Nucl Med Mol Imaging

451

318

View full text Add to dashboard Cite

show abstract

“…There are ample studies utilizing PSMA-based imaging agents for tumor detection in prostate cancer (24)(25)(26)(27)(28)(29)(30)(31), high-grade gliomas (32)(33)(34)(35)(36) and lung BMs (33), as well as in follicular thyroid adenoma (37), metastatic renal cell carcinoma (38) and in melanoma and small cell lung cancer (SCLC) xenografts in vivo (39). However, recent reports showed that the cerebral radionecrotic uptake (40) or stroke (41) resulted in false positive diagnoses of cerebral metastases based on PSMA/CT uptake as limitation of the PSMA-based diagnostic glioma imaging. A single arm phase II study where PSMArecognizing ADC was used in progressive GBM patients (n = 6) following prior treatment with radiation, temozolomide, and bevacizumab showed no demonstrable activity in these patients (NCT01856933).…”

Section: Discussionmentioning

confidence: 99%

Prostate Specific Membrane Antigen expression in the vasculature of primary lung carcinomas associates with faster metastatic dissemination to brain

Ramanathan

Lehtipuro

Sihto

et al. 2019

Preprint

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Glioblastomas and brain metastases (BM) of solid tumors are the most common central nervous system neoplasms associated with very unfavorable prognosis. In this study, we report the association of Prostate Specific Membrane Antigen with various clinical parameters in a large cohort of primary and secondary brain tumors. A tissue micro array containing 371 cases of ascending grade gliomas pertaining to astrocytic origin, samples of 52 cases of primary lung carcinomas with matching brain metastases with follow-up time accounting to 10.4 years was evaluated for PSMA expression using immunohistochemistry. In addition, PSMA expression was studied in brain metastases arising from melanomas and breast carcinomas. Neovascular expression of PSMA was evident alongside with high expression in the proliferating microvasculature of glioblastomas when compared to the tumor cell expression. This result corroborated with the results obtained from the in silico (cancer genome databases) analyses. In the matched primary lung cancers and their brain metastases (n = 52), vascular PSMA expression in primary tumors led to significantly accelerated metastatic dissemination to the brain with a tendency towards poor overall survival. Taken together, we report the vascular expression of PSMA in the primary and secondary brain tumors that globally associates with the malignant progression and poor outcome of the patients.

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“…PSMA-PET/CT positivity seems to be a usual phenomenon in Paget disease [5–8] that should be taken into consideration when PSMA-PET/CT is used during workup of patients with prostate cancer in order to avoid a pitfall in this otherwise accurate and sensitive diagnostic tool [1–3]. Beside Paget disease, various other tumors [11], coeliac ganglia [12], splenosis [13], sarcoidosis [14], and subacute stroke [15] have been reported to cause false-positive PSMA-PET imaging findings.…”

Section: Discussionmentioning

confidence: 99%

PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

Froehner

Toma

Zöphel

et al. 2017

Case Reports in Urology

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A 67-year-old man diagnosed with Gleason score 4 + 5 = 9 clinically localized prostate cancer with 68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease.

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Subacute Stroke Mimicking Cerebral Metastasis in 68Ga-PSMA-HBED-CC PET/CT

Cited by 56 publications

References 10 publications

Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients

Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients

Prostate Specific Membrane Antigen expression in the vasculature of primary lung carcinomas associates with faster metastatic dissemination to brain

PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

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