Abstract
68Ga-Prostate specific membrane antigen- N,N′-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N′-diacetic acid- positron emission tomography/computed tomography or 68 Ga- HBED-CC-PSMA PET/CT, popularly known as PSMA PET/CT, is able to detect a small volume of recurrent prostate carcinoma (PC) when there is a prostate specific antigen (PSA) rise on follow-up after prostatectomy or other definitive treatment for PC. The use of PSMA PET/CT in the initial staging in PC is uncertain at this time. Clinical studies are underway to define its exact role in the management of the disease. At the same time it is important to be aware of unexpected sites of uptake of this ligand. We present here the case of a 62-year-old male patient who underwent prostatectomy for adenocarcinoma prostate. He also had a long-standing left solitary thyroid nodule (STN). Four months after surgery, he had a rising trend in serum PSA levels on three occasions, but the absolute value was less than 4 at all times. He underwent a 68Ga-PSMA-HBED-CC PET/CT, but it did not reveal any recurrent/metastatic site of disease. However, there was increased tracer uptake in the left STN. Fine needle aspiration cytology revealed features of atypia of undetermined significance, Bethesda category III. The patient underwent a left hemithyroidectomy and the histopathology showed features of a follicular adenoma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Schäfer M, Bauder-Wüst U, Leotta K, Zoller F, Mier W, Haberkorn U, et al. A dimerized urea-based inhibitor of the prostate-specific membrane antigen for 68Ga-PET imaging of prostate cancer. EJNMMI Res. 2012;2:23.
Eder M, Neels O, Müller M, Bauder-Wüst U, Remde Y, Schäfer M, et al. Novel preclinical and radiopharmaceutical aspects of 68Ga-PSMA-HBED-CC: a new PET tracer for imaging of prostate cancer. Pharmaceuticals. 2014;7:779–96.
Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics. CA Cancer J Clin. 2014;64:9–29.
Silver DA, Pellicer I, Fair WR, Heston WD, Cordon-Cardo C. Prostate-specific membrane antigen expression in normal and malignant human tissues. Clin Cancer Res. 1997;3:81–5.
Schülke N, Varlamova OA, Donovan GP, Ma D, Gardner JP, Morrissey DM, et al. The homodimer of prostate-specific membrane antigen is a functional target for cancer therapy. Proc Natl Acad Sci U S A. 2003;100:12590–5.
Hellwig D, Moosbauer J, Eilles C. 68Ga-PSMA PET/CT for prostate cancer. Aktuelle Urol. 2014;45:457–63.
Chakraborty PS, Tripathi M, Agarwal KK, Kumar R, Vijay MK, Bal C. Metastatic poorly differentiated prostatic carcinoma with neuroendocrine differentiation: negative on 68Ga-PSMA PET/CT. Clin Nucl Med. 2015;40:163–6.
Bouchelouche K, Turkbey B, Choyke P, Capala J. Imaging prostate cancer: an update on positron emission tomography and magnetic resonance imaging. Curr Urol Rep. 2010;11:180–90.
Afshar-Oromieh A, Haberkorn U, Eder M, Eisenhut M, Zechmann CM. 68Ga-Gallium-labelled PSMA ligand as superior PET tracer for diagnosis of prostate cancer: comparison with 18F-FECH. Eur J Nucl Med Mol Imaging. 2012;39:1085–6.
Afshar-Oromieh A, Malcher A, Eder M, Eisenhut M, Linhart HG, Hadaschik BA, et al. PET imaging with a 68Ga-gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging. 2013;40:486–95.
Krohn T, Verburg FA, Pufe T, Neuhuber W, Vogg A, Heinzel A, et al. 68Ga-PSMA-HBED uptake mimicking lymph node metastasis in coeliac ganglia: an important pitfall in clinical practice. Eur J Nucl Med Mol Imaging. 2015;42:210–4.
Brindle R, Mullan D, Yap BK, Gandhi A. Thyroid incidentalomas discovered on positron emission tomography CT scanning—Malignancy rate and significance of standardised uptake values. Eur J Surg Oncol. 2014;40:1528–32.
Verburg FA, Krohn T, Heinzel A, Mottaghy FM, Behrendt FF. First evidence of PSMA expression in differentiated thyroid cancer using 68Ga-PSMA-HBED-CC PET/CT. Eur J Nucl Med Mol Imaging. 2015;42:1622–3.
Demirci E, Ocak M, Kabasakal L, Decristoforo C, Talat Z, Halaç M, et al. 68Ga-PSMA PET/CT imaging of metastatic clear cell renal cell carcinoma. Eur J Nucl Med Mol Imaging. 2014;41:1461–2.
Chang SS, Reuter VE, Heston WD, Bander NH, Grauer LS, Gaudin PB. Five different anti-prostate-specific membrane antigen (PSMA) antibodies confirm PSMA expression in tumor-associated neovasculature. Cancer Res. 1999;59:3192–8.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Nishikant Avinash Damle, Madhavi Tripathi, Partha Sarathi Chakraborty, Manas Kumar Sahoo, Chandrasekhar Bal, Shipra Aggarwal, Geetanjali Arora, Praveen Kumar, Rajeev Kumar, and Ravikant Gupta declare no conflict of interest.
Ethical Statement
The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The subject in the study gave written informed consent.
The manuscript has not been published before, is not under consideration for publication anywhere else and has been approved by all co-authors.
Rights and permissions
About this article
Cite this article
Damle, N.A., Tripathi, M., Chakraborty, P.S. et al. Unusual Uptake of Prostate Specific Tracer 68Ga-PSMA–HBED-CC in a Benign Thyroid Nodule. Nucl Med Mol Imaging 50, 344–347 (2016). https://doi.org/10.1007/s13139-016-0408-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13139-016-0408-y