Assessment of malignancy and PSMA expression of uncertain bone foci in [18F]PSMA-1007 PET/CT for prostate cancer—a single-centre experience of PET-guided biopsies

• DOI: 10.1007/s00259-022-05745-5
• Publication Date: 2022-04-28T08:03:14Z
• Authors: Bernd Vollnberg; Ian Alberts; Vera Genitsch; Axel Rominger; Ali Afshar-Oromieh
• Keywords: PET-CT

Abstract Purpose Uncertain focal bone uptake (UBU) with intensive radiopharmaceutical avidity are frequently observed in patients undergoing [ 18 F]PSMA-1007 PET/CT for the detection of prostate cancer (PC). Such foci can pose diagnostic conundrums and risk incorrect staging. The aim this short communication is to share results PET-guided biopsies such foci. Methods A retrospective analysis revealed 10 who were referred our department biopsy UBU visible a previous PET/CT. F]-PSMA-1007 was conducted 11 PSMA-avid these patients. materials analysed tissue typing, immunohistochemistry (IHC) performed prostate-specific-membrane-antigen (PSMA) expression. scans by two experienced physicians consensus read clinical characteristics Results One out (9.1%) biopsied confirmed as metastasis PC intense PSMA-expression, while 10/11 (90.9%) be unremarkable without evidence PSMA expression at IHC. Amongst all assessed biopsy, eight visually classified being high malignancy (SUVmean 12.0 ± 8.1; SUVmax 18.8 13.1), three equivocal 4.6 2.1; 7.2 3.0) zero low risk. No had any CT correlate. Conclusions This cohort that small but relevant number true metastases. For those benign, no IHC observed, suggesting non-PSMA mediated cause which reason remains unclear. Readers must interpret caution order reduce erroneous staging subsequent treatment. particularly absence morphological changes CT, useful method clarify