[68Ga]PSMA-11, which is the most frequently applied tracer, has shown to detect lymph node metastases, local recurrences, distant metastases and intraprostatic foci with high sensitivity, even at relatively low PSA levels.
We report a case of Ga-PSMA PET/MR-positive peritoneal metastasis as site of primary relapse after definitive PCa treatment in a 58-year-old man with a prostate-specific antigen of 30 ng/mL at time of the study.
We have mapped the human prostate-specific membrane antigen (PSM) gene to the chromosome 11p11.2 region at 62.5 cM, a region which also contains the prostatic cancer metastasis suppressor gene KAI-1.
We describe the technique using PSMA-PET imaging to pre-operatively localise areas of low-volume nodal metastatic disease with hookwire to allow targeted lymph node dissection with direct visualisation and palpation to ensure adequate clearance of involved nodes.
To evaluate the diagnostic performance of [<sup>68</sup>Ga]Ga-PSMA<sup>HBED-CC</sup> conjugate 11 positron emission tomography (PSMA-PET) in the early detection of metastases in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) for clinically non-metastatic prostate cancer, to compare it to CT/MRI alone and to assess its impact on further therapeutic decisions.
Thus, PSMA has theoretically been discussed as a possible future target for systemic radioligand therapy with <sup>177</sup>Lu-PSMA-617 even in non-prostate malignancies 1.Here we report on a female patient with extended metastasized leiomyosarcoma experimentally treated with one application of <sup>177</sup>Lu-PSMA-617 radioligand therapy.
This pattern of distant metastatic spread is a rare presentation of PC, and PSMA PET/CT revealed the unusual metastasis in the inguinal canal with a timely therapy culminating in favorable disease response.
This is a rare but important potential pitfall in Ga-PSMA PET/CT-a soft tissue lesion with intense tracer uptake related not to a nodal metastasis of prostate cancer but to extraosseous extension of an aggressive vertebral body hemangioma.
This case shows the importance of including schwannoma in the differential diagnostic evaluation of patients with Ga-PSMA-positive foci in paravertebral locations, as schwannomas may show avid PSMA uptake and may potentially lead to an incorrect diagnosis of metastasis.
This case highlights the ability of gallium-68 prostate-specific membrane antigen positron emission tomography for prostate carcinoma characterization and the importance of always considering atypical patterns of metastatic disease.
Therefore, the present study aimed to evaluate the role of PSMA PET/CT in detecting nodal metastases in a large cohort of men and compare imaging results with the risk of lymph node involvement based on the Roach formula.
The use of radio-labelled peptides with high affinity for PSMA-receptor allows for localization of oligo-metastasis to guide salvage lymph node (LN) dissection, and effective delivery of radionuclide therapy to PCa cells.
The type II integral membrane protein, prostate specific membrane antigen (PSMA) is overexpressed on prostate cancer cells in proportion to the stage and grade of the tumor progression, especially in androgen-independent, advanced and metastatic disease, rendering it a promising diagnostic and/or therapeutic target.
The mean SUV<sub>max</sub> of PSMA-negative metastases was 1.0±0.5 in 2D ROI and 1.0±0.4 in 3D ROI, and significantly lower than that of the pulmonary opacities (p<0.001).
The highest significant positive correlation between LN size and SUV was in patients with pelvic and abdominal LN metastases without bone involvement according to the gallium-68 PSMA PET/computed tomography images in our study.
The high prostate-specific membrane antigen expression in prostate cancer metastases makes it a promising approach for targeted radionuclide therapy of prostate cancer.
The detection rate of prostate origin of metastasis for single markers was 100% for NKX3.1, 98.1% for AR, 84.3% for PSMA, 80.8% for PSA, 66% for PSAP, 60.4% for HOXB13, 59.6% for prostein, and 50.0% for ERG.
The prostate-specific membrane antigen (PSMA) has emerged as an interesting target for radionuclide therapy of metastasized castration-resistant prostate cancer (mCRPC).