Impact of PSMA PET/CT in prostate cancer patient’s clinical management: a pictorial essay of interesting cases with histologic confirmation

Abstract

Introduction

Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) has a significant impact on prostate cancer (PCa) patient’s clinical management. PSMA PET/CT has changed both the paradigm of metastases spread pathway, and the PSMA specificity for detecting PCa lesions. Currently, it is accepted that PCa can spread to cervical and mediastinal lymph nodes without other intermediate lesions. PSMA expression in non-prostate cancers or benign lesions is known as well. However, information about PSMA functional specificity in clinical practice is still missing.

Methods

A retrospective analysis of PSMA PET/CT studies was done to select relevant clinical cases with complete clinical history, histology results and follow-up information. Each clinical case was organized from a holistic perspective, including clinical information, 68Ga-PSMA PET/CT images, pathology results and clinical outcome.

Results

Nine clinical cases were selected to illustrate synchronous primary cancers (gastric gastrointestinal stromal tumours and clear cell renal cell carcinoma), atypical sites of PCa metastases (thyroid, liver, cervical and mediastinal lymph nodes) and some examples of PCa lung metastases with discordant PSMA findings between PET/CT examinations and immunohistochemistry.

Discussion

In this pictorial essay and review, the meaning of high PSMA expression in neovasculature and uncommon PCa metastatic spread were addressed. Furthermore, recent information about the possible explanation of (1) PCa metastases without PSMA expression due to dedifferentiation and specific PCa subtypes, and (2) some discordant findings on PSMA expression evaluated by PET/CT and immunohistochemistry related to the anti-PSMA antibody used in each technique is presented.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21

References

  1. 1.

    Low PS, Chelvams V, Kim Y. PSMA binding ligand-linker conjugates and methods for using. WO 2011/106639, PCT/US2011/026238. https://patents.google.com/patent/WO2011106639A1/en

  2. 2.

    Lindenberg L, Choyke P, Dahut W (2016) Prostate cancer imaging with novel PET tracers. Curr Urol Rep. https://doi.org/10.1007/s11934-016-0575-5

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Meller B, Bremmer F, Sahlmann CO, Hijazi S, Bouter C, Trojan L et al (2015) Alterations in androgen deprivation enhanced prostate-specific membrane antigen (PSMA) expression in prostate cancer cells as a target for diagnostics and therapy. EJNMMI Res. https://doi.org/10.1186/s13550-015-0145-8

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Rajasekaran SA, Anilkumar G, Oshima E, Bowie JU, Liu H, Heston W et al (2003) A novel cytoplasmic tail MXXXL motif mediates the internalization of prostate-specific membrane antigen. Mol Biol Cell. https://doi.org/10.1091/mbc.e02-11-0731

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Grauer LS, Lawler KD, Marignac JL, Kumar A, Goel AS, Wolfert RL (1998) Identification, purification, and subcellular localization of prostate-specific membrane antigen PSM' protein in the lncap prostatic carcinoma cell line. Cancer Res 58(21):4787–4789

    CAS  PubMed  Google Scholar 

  6. 6.

    O'Keefe DS, Bacich DJ, Huang SS, Heston WDW (2018) A Perspective on the evolving story of PSMA biology, PSMA-based imaging, and endoradiotherapeutic strategies. J Nucl Med. https://doi.org/10.2967/jnumed.117.203877

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Carter RE, Feldman AR, Coyle JT (1996) Prostate-specific membrane antigen is a hydrolase with substrate and pharmacologic characteristics of a neuropeptidase. Proc Natl Acad Sci. https://doi.org/10.1073/pnas.93.2.749

    Article  PubMed  Google Scholar 

  8. 8.

    Sweat SD, Pacelli A, Murphy GP, Bostwick DG (1998) Prostate-specific membrane antigen expression is greatest in prostate adenocarcinoma and lymph node metastases. Urology. https://doi.org/10.1016/s0090-4295(98)00278-7

    Article  PubMed  Google Scholar 

  9. 9.

    Kahn D, Williams RD, Manyak MJ, Haseman MK, Seldin DW, Libertino JA et al (1998) 111Indium-capromab pendetide in the evaluation of patients with residual or recurrent prostate cancer after radical prostatectomy. The ProstaScint Study Group. J Urol 159(6):2041–2047

    CAS  Article  Google Scholar 

  10. 10.

    Backhaus P, Noto B, Avramovic N, Grubert LS, Huss S, Bogemann M et al (2018) Targeting PSMA by radioligands in non-prostate disease-current status and future perspectives. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-017-3922-y

    Article  PubMed  Google Scholar 

  11. 11.

    Liu H, Moy P, Kim S, Xia Y, Rajasekaran A, Navarro V et al (1997) Monoclonal antibodies to the extracellular domain of prostate-specific membrane antigen also react with tumor vascular endothelium. Cancer Res 57(17):3629–3634

    CAS  PubMed  Google Scholar 

  12. 12.

    Bander NH, Milowsky MI, Nanus DM, Kostakoglu L, Vallabhajosula S, Goldsmith SJ (2005) Phase I trial of 177lutetium-labeled J591, a monoclonal antibody to prostate-specific membrane antigen, in patients with androgen-independent prostate cancer. J Clin Oncol. https://doi.org/10.1200/JCO.2005.05.160

    Article  PubMed  Google Scholar 

  13. 13.

    Weineisen M, Schottelius M, Simecek J, Baum RP, Yildiz A, Beykan S et al (2015) 68Ga- and 177Lu-labeled PSMA I&T: optimization of a PSMA-targeted theranostic concept and first proof-of-concept human studies. J Nucl Med. https://doi.org/10.2967/jnumed.115.158550

    Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Afshar-Oromieh A, Babich JW, Kratochwil C, Giesel FL, Eisenhut M, Kopka K et al (2016) The rise of psma ligands for diagnosis and therapy of prostate cancer. J Nucl Med. https://doi.org/10.2967/jnumed.115.170720

    Article  PubMed  Google Scholar 

  15. 15.

    Kesch C, Kratochwil C, Mier W, Kopka K, Giesel FL (2017) (68)Ga or (18)F for prostate cancer imaging? J Nucl Med. https://doi.org/10.2967/jnumed.117.190157

    Article  PubMed  Google Scholar 

  16. 16.

    Czarniecki M, Mena E, Lindenberg L, Cacko M, Harmon S, Radtke JP et al (2018) Keeping up with the prostate-specific membrane antigens (PSMAs): an introduction to a new class of positron emission tomography (PET) imaging agents. Transl Androl Urol. https://doi.org/10.21037/tau.2018.08.03

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Afshar-Oromieh A, Avtzi E, Giesel FL, Holland-Letz T, Linhart HG, Eder M et al (2015) The diagnostic value of PET/CT imaging with the 68Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-014-2949-6

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Herlemann A, Wenter V, Kretschmer A, Thierfelder KM, Bartenstein P, Faber C et al (2016) 68Ga-PSMA positron emission tomography/computed tomography provides accurate staging of lymph node regions prior to lymph node dissection in patients with prostate cancer. Eur Urol. https://doi.org/10.1016/j.eururo.2015.12.051

    Article  PubMed  Google Scholar 

  19. 19.

    Maurer T, Gschwend JE, Rauscher I, Souvatzoglou M, Haller B, Weirich G et al (2016) Diagnostic efficacy of %3csup arrange=“stack”%3e68%3c/sup%3egallium-PSMA positron emission tomography compared to conventional imaging for lymph node staging of 130 consecutive patients with intermediate to high risk prostate cancer. J Urol. https://doi.org/10.1016/j.juro.2015.12.025

    Article  PubMed  Google Scholar 

  20. 20.

    Afshar-Oromieh A, Holland-Letz T, Giesel FL, Kratochwil C, Mier W, Haufe S et al (2017) Diagnostic performance of (68)Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-017-3711-7

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Eiber M, Maurer T, Souvatzoglou M, Beer AJ, Ruffani A, Haller B et al (2015) Evaluation of hybrid (68)Ga-PSMA ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy. J Nucl Med. https://doi.org/10.2967/jnumed.115.154153

    Article  PubMed  Google Scholar 

  22. 22.

    Lenzo NP, Meyrick D, Turner JH (2018) Review of gallium-68 PSMA PET/CT imaging in the management of prostate cancer. Diagnostics (Basel). https://doi.org/10.3390/diagnostics8010016

    Article  Google Scholar 

  23. 23.

    Fendler WP, Eiber M, Beheshti M, Bomanji J, Ceci F, Cho S et al (2017) (68)Ga-PSMA PET/CT: joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-017-3670-z

    Article  PubMed  Google Scholar 

  24. 24.

    Fanti S, Minozzi S, Antoch G, Banks I, Briganti A, Carrio I et al (2018) Consensus on molecular imaging and theranostics in prostate cancer. Lancet Oncol. https://doi.org/10.1016/S1470-2045(18)30604-1

    Article  PubMed  Google Scholar 

  25. 25.

    Keidar Z, Gill R, Goshen E, Israel O, Davidson T, Morgulis M et al (2018) 68Ga-PSMA PET/CT in prostate cancer patients: patterns of disease, benign findings and pitfalls. Cancer Imaging. https://doi.org/10.1186/s40644-018-0175-3

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Hofman MS, Hicks RJ, Maurer T, Eiber M (2018) Prostate-specific membrane antigen PET: clinical utility in prostate cancer, normal patterns, pearls, and pitfalls. Radiographics. https://doi.org/10.1148/rg.2018170108

    Article  PubMed  Google Scholar 

  27. 27.

    Silver DA, Pellicer I, Fair WR, Heston WD, Cordon-Cardo C (1997) Prostate-specific membrane antigen expression in normal and malignant human tissues. Clin Cancer Res 3(1):81–85

    CAS  PubMed  Google Scholar 

  28. 28.

    Schwarzenboeck SM, Rauscher I, Bluemel C, Fendler WP, Rowe SP, Pomper MG et al (2017) PSMA ligands for PET imaging of prostate cancer. J Nucl Med. https://doi.org/10.2967/jnumed.117.191031

    Article  PubMed  Google Scholar 

  29. 29.

    Shetty D, Patel D, Le K, Bui C, Mansberg R (2018) Pitfalls in gallium-68 PSMA PET/CT interpretation: a pictorial review. Tomography. https://doi.org/10.18383/j.tom.2018.00021

    Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Malik D, Sood A, Mittal BR, Singh H, Basher RK, Shukla J et al (2018) Nonspecific uptake of (68)Ga-prostate-specific membrane antigen in diseases other than prostate malignancy on positron emission tomography/computed tomography imaging: a pictorial assay and review of literature. Indian J Nucl Med. https://doi.org/10.4103/ijnm.IJNM_81_18

    Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Salas Fragomeni RA, Amir T, Sheikhbahaei S, Harvey SC, Javadi MS, Solnes LB et al (2018) Imaging of nonprostate cancers using PSMA-targeted radiotracers: rationale, current state of the field, and a call to arms. J Nucl Med. https://doi.org/10.2967/jnumed.117.203570

    Article  PubMed  Google Scholar 

  32. 32.

    Van de Wiele C, Sathekge M, de Spiegeleer B, de Jonghe PJ, Beels L, Maes A (2019) PSMA-targeting positron emission agents for imaging solid tumors other than non-prostate carcinoma: a systematic review. Int J Mol Sci. https://doi.org/10.3390/ijms20194886

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Demirci E, Sahin OE, Ocak M, Akovali B, Nematyazar J, Kabasakal L (2016) Normal distribution pattern and physiological variants of 68Ga-PSMA-11 PET/CT imaging. Nucl Med Commun. https://doi.org/10.1097/MNM.0000000000000566

    Article  PubMed  Google Scholar 

  34. 34.

    Osman MM, Iravani A, Hicks RJ, Hofman MS (2017) Detection of synchronous primary malignancies with (68)Ga-labeled prostate-specific membrane antigen PET/CT in patients with prostate cancer: frequency in 764 patients. J Nucl Med. https://doi.org/10.2967/jnumed.117.190215

    Article  PubMed  Google Scholar 

  35. 35.

    Noto B, Weckesser M, Buerke B, Pixberg M, Avramovic N (2017) Gastrointestinal stromal tumor showing intense tracer uptake on PSMA PET/CT. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001491

    Article  PubMed  Google Scholar 

  36. 36.

    Vaz S, Oliveira C, Castanheira JC, Silva AF, Costa DC (2018) Gastric GIST incidentally detected on 68Ga-PSMA-PET/CT: correlation between functional imaging and histology. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000002347

    Article  PubMed  Google Scholar 

  37. 37.

    Rowe SP, Gorin MA, Hammers HJ, Som Javadi M, Hawasli H, Szabo Z et al (2015) Imaging of metastatic clear cell renal cell carcinoma with PSMA-targeted (1)(8)F-DCFPyL PET/CT. Ann Nucl Med. https://doi.org/10.1007/s12149-015-1017-z

    Article  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Rhee H, Ng KL, Tse BW, Yeh MC, Russell PJ, Nelson C et al (2016) Using prostate specific membrane antigen (PSMA) expression in clear cell renal cell carcinoma for imaging advanced disease. Pathology. https://doi.org/10.1016/j.pathol.2016.05.011

    Article  PubMed  Google Scholar 

  39. 39.

    Sawicki LM, Buchbender C, Boos J, Giessing M, Ermert J, Antke C et al (2017) Diagnostic potential of PET/CT using a (68)Ga-labelled prostate-specific membrane antigen ligand in whole-body staging of renal cell carcinoma: initial experience. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-016-3360-2

    Article  PubMed  Google Scholar 

  40. 40.

    Heitkotter B, Steinestel K, Trautmann M, Grunewald I, Barth P, Gevensleben H et al (2018) Neovascular PSMA expression is a common feature in malignant neoplasms of the thyroid. Oncotarget. https://doi.org/10.18632/oncotarget.23984

    Article  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Lakshminarayanan M, Kurian A (2017) A rare presentation of metastasis to the thyroid gland. J Clin Diagn Res. https://doi.org/10.7860/JCDR/2017/24696.9709

    Article  PubMed  PubMed Central  Google Scholar 

  42. 42.

    Selimoglu H, Duran C, Saraydaroglu O, Guclu M, Kiyici S, Ersoy C et al (2007) Prostate cancer metastasis to thyroid gland. Tumori 93(3):292–295

    Article  Google Scholar 

  43. 43.

    Derlin T, Kreipe HH, Schumacher U, Soudah B (2017) PSMA expression in tumor neovasculature endothelial cells of follicular thyroid adenoma as identified by molecular imaging using 68Ga-PSMA ligand PET/CT. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001487

    Article  PubMed  Google Scholar 

  44. 44.

    Damle NA, Tripathi M, Chakraborty PS, Sahoo MK, Bal C, Aggarwal S et al (2016) Unusual uptake of prostate specific tracer (68)Ga-PSMA-HBED-CC in a benign thyroid nodule. Nucl Med Mol Imaging. https://doi.org/10.1007/s13139-016-0408-y

    Article  PubMed  PubMed Central  Google Scholar 

  45. 45.

    Bertagna F, Albano D, Giovanella L, Bonacina M, Durmo R, Giubbini R et al (2019) (68)Ga-PSMA PET thyroid incidentalomas. Hormones (Athens, Greece). https://doi.org/10.1007/s42000-019-00106-8

    Article  Google Scholar 

  46. 46.

    Chausse G, Niazi T, Abikhzer GS, Probst SM (2017) Biopsy-proven diffuse mediastinal prostate cancer metastases negative on 18F-fluorocholine, diagnosed on 68Ga-PSMA and 18F-PSMA PET/CT. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001766

    Article  PubMed  Google Scholar 

  47. 47.

    Cho KR, Epstein JI (1987) Metastatic prostatic carcinoma to supradiaphragmatic lymph nodes. A clinicopathologic and immunohistochemical study. Am J Surg Pathol. https://doi.org/10.1097/00000478-198706000-00006

    Article  PubMed  Google Scholar 

  48. 48.

    Damjanovic J, Janssen JC, Furth C, Diederichs G, Walter T, Amthauer H et al (2018) (68) Ga-PSMA-PET/CT for the evaluation of pulmonary metastases and opacities in patients with prostate cancer. Cancer Imaging. https://doi.org/10.1186/s40644-018-0154-8

    Article  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Kume H, Takai K, Kameyama S, Kawabe K (1999) Multiple pulmonary metastasis of prostatic carcinoma with little or no bone or lymph node metastasis. Report of two cases and review of the literature. Urol Int. https://doi.org/10.1159/000030355

    Article  PubMed  Google Scholar 

  50. 50.

    Gago JP, Camara G, Dionisio J, Opiniao A (2016) Pulmonary metastasis as sole manifestation of relapse in previously treated localised prostate cancer: three exceptional case reports. Ecancermedicalscience. https://doi.org/10.3332/ecancer.2016.645

    Article  PubMed  PubMed Central  Google Scholar 

  51. 51.

    Pyka T, Weirich G, Einspieler I, Maurer T, Theisen J, Hatzichristodoulou G et al (2016) 68Ga-PSMA-HBED-CC PET for differential diagnosis of suggestive lung lesions in patients with prostate cancer. J Nucl Med. https://doi.org/10.2967/jnumed.115.164442

    Article  PubMed  Google Scholar 

  52. 52.

    Bouchelouche K, Vendelbo MH (2017) Pulmonary opacities and bronchiectasis avid on 68Ga-PSMA PET. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001568

    Article  PubMed  Google Scholar 

  53. 53.

    Ardies PJ, Gykiere P, Goethals L, De Mey J, De Geeter F, Everaert H (2017) PSMA uptake in mediastinal sarcoidosis. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001543

    Article  PubMed  Google Scholar 

  54. 54.

    Smith CP, Sharma A, Ayala G, Cagle P, Kadmon D (1999) Solitary pulmonary metastasis from prostate cancer. J Urol. https://doi.org/10.1016/s0022-5347(05)68118-9

    Article  PubMed  Google Scholar 

  55. 55.

    Hofland CA, Bagg MD (2000) An isolated pulmonary metastasis in prostate cancer. Mil Med 165(12):973–974

    CAS  Article  Google Scholar 

  56. 56.

    Shetty D, Loh H, Bui C, Mansberg R, Stevanovic A (2016) Elevated 68Ga prostate-specific membrane antigen activity in metastatic non-small cell lung cancer. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001139

    Article  PubMed  Google Scholar 

  57. 57.

    Wang HL, Wang SS, Song WH, Pan Y, Yu HP, Si TG et al (2015) Expression of prostate-specific membrane antigen in lung cancer cells and tumor neovasculature endothelial cells and its clinical significance. PLoS ONE. https://doi.org/10.1371/journal.pone.0125924

    Article  PubMed  PubMed Central  Google Scholar 

  58. 58.

    Damjanovic J, Janssen JC, Prasad V, Diederichs G, Walter T, Brenner W et al (2019) (68)Ga-PSMA-PET/CT for the evaluation of liver metastases in patients with prostate cancer. Cancer Imaging. https://doi.org/10.1186/s40644-019-0220-x

    Article  PubMed  PubMed Central  Google Scholar 

  59. 59.

    Pouessel D, Gallet B, Bibeau F, Avances C, Iborra F, Senesse P et al (2007) Liver metastases in prostate carcinoma: clinical characteristics and outcome. BJU Int. https://doi.org/10.1111/j.1464-410X.2006.06663.x

    Article  PubMed  Google Scholar 

  60. 60.

    Conway RE, Petrovic N, Li Z, Heston W, Wu D, Shapiro LH (2006) Prostate-specific membrane antigen regulates angiogenesis by modulating integrin signal transduction. Mol Cell Biol. https://doi.org/10.1128/mcb.00084-06

    Article  PubMed  PubMed Central  Google Scholar 

  61. 61.

    Conway RE, Joiner K, Patterson A, Bourgeois D, Rampp R, Hannah BC et al (2013) Prostate specific membrane antigen produces pro-angiogenic laminin peptides downstream of matrix metalloprotease-2. Angiogenesis. https://doi.org/10.1007/s10456-013-9360-y

    Article  PubMed  Google Scholar 

  62. 62.

    Conway RE, Rojas C, Alt J, Novakova Z, Richardson SM, Rodrick TC et al (2016) Prostate-specific membrane antigen (PSMA)-mediated laminin proteolysis generates a pro-angiogenic peptide. Angiogenesis. https://doi.org/10.1007/s10456-016-9521-x

    Article  PubMed  Google Scholar 

  63. 63.

    Parimi V, Goyal R, Poropatich K, Yang XJ (2014) Neuroendocrine differentiation of prostate cancer: a review. Am J Clin Exp Urol 2(4):273–285

    PubMed  PubMed Central  Google Scholar 

  64. 64.

    Woythal N, Arsenic R, Kempkensteffen C, Miller K, Janssen JC, Huang K et al (2018) Immunohistochemical validation of PSMA expression measured by (68)Ga-PSMA PET/CT in primary prostate cancer. J Nucl Med. https://doi.org/10.2967/jnumed.117.195172

    Article  PubMed  Google Scholar 

  65. 65.

    Harmon S, Mena E, Adler S, Ton A, Mease R, Pomper M et al (2018) Semi-quantitative comparison of 18F-DCFBC PET/CT and PSMA immunohistochemistry. J Nucl Med 59 (supplement 1):1480

    Google Scholar 

  66. 66.

    Mannweiler S, Amersdorfer P, Trajanoski S, Terrett JA, King D, Mehes G (2009) Heterogeneity of prostate-specific membrane antigen (PSMA) expression in prostate carcinoma with distant metastasis. Pathol Oncol Res. https://doi.org/10.1007/s12253-008-9104-2

    Article  PubMed  Google Scholar 

  67. 67.

    Zhigang Z, Wenlv S (2004) Prostate stem cell antigen (PSCA) expression in human prostate cancer tissues and its potential role in prostate carcinogenesis and progression of prostate cancer. World J Surg Oncol. https://doi.org/10.1186/1477-7819-2-13

    Article  PubMed  PubMed Central  Google Scholar 

  68. 68.

    Guo Y, Mao S, Zhang A, Wang R, Zhang Z, Zhang J et al (2019) Prognostic significance of young age and non-bone metastasis at diagnosis in patients with metastatic prostate cancer: a SEER population-based data analysis. J Cancer. https://doi.org/10.7150/jca.29481

    Article  PubMed  PubMed Central  Google Scholar 

  69. 69.

    Vinjamoori AH, Jagannathan JP, Shinagare AB, Taplin ME, Oh WK, Van den Abbeele AD et al (2012) Atypical metastases from prostate cancer: 10-year experience at a single institution. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.11.7533

    Article  PubMed  Google Scholar 

  70. 70.

    Bubendorf L, Schopfer A, Wagner U, Sauter G, Moch H, Willi N et al (2000) Metastatic patterns of prostate cancer: an autopsy study of 1589 patients. Hum Pathol. https://doi.org/10.1053/hp.2000.6698

    Article  PubMed  Google Scholar 

  71. 71.

    Gandaglia G, Abdollah F, Schiffmann J, Trudeau V, Shariat SF, Kim SP et al (2014) Distribution of metastatic sites in patients with prostate cancer: a population-based analysis. Prostate. https://doi.org/10.1002/pros.22742

    Article  PubMed  Google Scholar 

  72. 72.

    Copeland B, Clark JM, Sura A, Kilpatrick SE, Shockley W, Meredith S (2001) Prostate carcinoma metastatic to the cervical lymph nodes: report of two cases and review of the literature. Am J Otolaryngol. https://doi.org/10.1053/ajot.2001.28066

    Article  PubMed  Google Scholar 

  73. 73.

    Saitoh H, Hida M, Shimbo T, Nakamura K, Yamagata J, Satoh T (1984) Metastatic patterns of prostatic cancer. Correlation between sites and number of organs involved. Cancer. https://doi.org/10.1002/1097-0142(19841215)54:12%3c3078:aid-cncr2820541245%3e3.0.co;2-u

    Article  PubMed  Google Scholar 

  74. 74.

    Flocks RH, Boatman DL (1973) Incidence of head and neck metastases from genito-urinary neoplasms. Laryngoscope. https://doi.org/10.1288/00005537-197309000-00011

    Article  PubMed  Google Scholar 

  75. 75.

    Jones H, Anthony PP (1992) Metastatic prostatic carcinoma presenting as left-sided cervical lymphadenopathy: a series of 11 cases. Histopathology. https://doi.org/10.1111/j.1365-2559.1992.tb00363.x

    Article  PubMed  Google Scholar 

  76. 76.

    Wang HJ, Chiang PH, Peng JP, Yu TJ (2004) Presentation of prostate carcinoma with cervical lymphadenopathy: report of three cases. Chang Gung Med J 27(11):840–844

    PubMed  Google Scholar 

  77. 77.

    Wang W, Epstein JI (2008) Small cell carcinoma of the prostate. A morphologic and immunohistochemical study of 95 cases. Am J Surg Pathol. https://doi.org/10.1097/PAS.0b013e318058a96b

    Article  PubMed  PubMed Central  Google Scholar 

  78. 78.

    Gordon IO, Tretiakova MS, Noffsinger AE, Hart J, Reuter VE, Al-Ahmadie HA (2008) Prostate-specific membrane antigen expression in regeneration and repair. Mod Pathol. https://doi.org/10.1038/modpathol.2008.143

    Article  PubMed  Google Scholar 

  79. 79.

    Wang H, Li B, Zhang P, Yao Y, Chang J (2014) Clinical characteristics and prognostic factors of prostate cancer with liver metastases. Tumour Biol. https://doi.org/10.1007/s13277-013-1083-6

    Article  PubMed  PubMed Central  Google Scholar 

  80. 80.

    Usmani S, Ahmed N, Marafi F, Rasheed R, Amanguno HG, Al KF (2017) Molecular imaging in neuroendocrine differentiation of prostate cancer: 68Ga-PSMA versus 68Ga-DOTA NOC PET-CT. Clin Nucl Med. https://doi.org/10.1097/RLU.0000000000001618

    Article  PubMed  Google Scholar 

Download references

Funding

There was no funding for this paper.

Author information

Affiliations

Authors

Contributions

SV, AS and CO contributed to the study conception and design. Data collection was done by SV. PET/CT analyses were done by SV, AS and CO. Immunohistochemistry analyses were done by MCM, RM and AG. The first draft of the manuscript was written by SV and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sofia Carrilho Vaz.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Carrilho Vaz, S., Silva, Â., Oliveira, C. et al. Impact of PSMA PET/CT in prostate cancer patient’s clinical management: a pictorial essay of interesting cases with histologic confirmation. Clin Transl Imaging 8, 207–226 (2020). https://doi.org/10.1007/s40336-020-00372-2

Download citation

Keywords

  • PSMA
  • PET/CT
  • Immunohistochemistry
  • Pitfalls
  • Specificity
  • Prostate cancer