Patterns of Physiologic 18F-DCFPyL PSMA PET/CT Uptake in Ganglia: A Pictorial Essay

1152Objectives: 1. To recognize patterns of 18F-DCFPyL uptake in ganglia which may mimic lymph node metastases at different anatomic locations. 2. To understand the role of CT characterization and localization in the differentiation of benign 18F-DCFPyL uptake in ganglia versus metastatic lymph nodes. 3. How to interpret these findings and direct further evaluation or recommendation if needed. Abstract Several recent studies revealed accurate staging of primary prostate cancer (PC) and restaging after biochemical recurrence with 68Ga -PSMA11 PET/CT (1-3). However, PSMA uptake is not completely specific to PC (4). Whilst experience initially evolved with 68Ga -PSMA11 PET/CT there is increasing use of 18F-labelled PSMA radiotracers, which may have advantages for large scale good manufacturing practice (GMP) production, and further improve imaging quality owing to better nuclear decay characteristics including shorter positron emission range (5). PSMA uptake was initially described in coeliac ganglia where it may mimic lymph node metastases (6). However, PSMA uptake in ganglia is not limited to coeliac only and may present at different ganglia within the imaged field of view. We have observed different patterns of ganglion visualization with 18F-DCFPyL compared to 68Ga-PSMA11. This includes more frequent visualization of cervical and sacral ganglia, which may be attributable to better imaging characteristics with 18F PET imaging. Furthermore, it has been recently demonstrated t...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Source Type: research