Abstract
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Introduction: Prostate-specific membrane antigen (PSMA) is a highly used target for PET CT imaging of prostate cancer. Despite its name, there are non-prostate-related PSMA expression in physiologic tissue as well as in malignant and benign diseases. Unlike in prostate cancer, PSMA expression is only not often seen in non-prostate tumor cells. This expression happens to occur in endothelial cells in the neovasculature of tumor. This can result in potential tumor staging in non-prostate malignant tumors seen in many patients.
Methods: 1400 patients where reviewed in a one year time frame to evaluate for prostate cancer with both Ga-68 and F-18 PSMA PET CT imaging agents. These scans were done in accordance to manufactories guidelines of mCi amount and wait time for the PETCT scan. All of the images were reviewed by nuclear medicine physicians and SUV were calculated.
Results: PSMA PET/CT plays a key role in diagnosis, staging and evaluation of treatment response of prostate cancer. Prostate cancer was seen on many patients as well as variety of conditions presenting PSMA uptake on PET imaging, from inflammatory processes and benign tumors. Correlations of imaging findings were also reviewed in MRI and CT as well as patient history. These include PSMA uptake in many different disease, CNS, head and neck, thyroid, adrenal, GIST, liver and Paget’s
Conclusions: Because of the widespread use of PSMA PET CT worldwide in clinical imaging sites the molecular imaging community will be seeing PSMA expression in the neo-vasculature of many various solid tumors and infections. This expanding use of PSMA PET has revealed PSMA ligand uptake in diverse non-prostatic diseases. Although these diseases are not common, as the growing number PSMA PET CT scan are done more of these pathologies presenting PSMA uptake will be reported. Knowing and differentiating these varieties of non-prostatic diseases from metastatic prostate cancer will help with proper interpretation of PSMA PET imaging findings.
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