Primary mesenchymal tumors of the prostate in ¹⁸F-FDG PET/CT: A pictorial essay.

Objectives: 1. To review the literature of prostate primary mesenchymal tumors, 2. To evaluate the features of ¹⁸F-FDG PET/CT imaging, 3. To summarize the advantages and disadvantages of ¹⁸F-FDG PET/CT, and 4. To propose diagnostic strategies. Primary mesenchymal tumors of the prostate are extremely rare, which occupy less than 1% of all prostate tumors. However, due to lack of experience, it often caused considerable diagnostic difficulty when encountered. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT), which combined anatomical and metabolic information, could serve as a more powerful non-invasive modality in the diagnose of prostate primary mesenchymal tumors than CT alone. In this educational exhibit, we will present three cases of prostate primary mesenchymal tumors: prostate rhabdomyosarcoma, primary prostate stromal sarcoma and prostate solitary fibrous tumor. The clinical manifestations, pathology and PET/CT features will be reviewed. Combining with previous reports, we will summarize the advantages and disadvantages of ¹⁸F-FDG PET/CT in the clinical utility of prostate primary mesenchymal tumors. With the guidance of ¹⁸F-FDG PET/CT, the diagnostic accuracy rate of pathology will be improved. With the information presented, the nuclear medicine physicians and presidents will be able to optimize the use of PET/CT in imaging of patients with prostate primary mesenchymal tumors.