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Comparative Findings Between 68Ga-PSMA and 18F-FDG PET/CT for Hepatocellular Carcinoma

10.4274/mirt.galenos.2020.50455

  • Seval Erhamamcı
  • Nesrin Aslan

Received Date: 26.04.2020 Accepted Date: 29.06.2020 Mol Imaging Radionucl Ther 2020;29(3):135-138 PMID: 33094578

We have reported here the case of a 69-year-old man who presented with spinal cord compression due to bone metastases as the first manifestation of hepatocellular carcinoma (HCC). For the initial staging, the patient underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) imaging, which demonstrated mild 18F-FDG uptake in the multiple expansile osteolytic bone lesions, but no remarkable atypical 18F-FDG uptake in the liver lesion on low-doses CT. An additional PET/CT scan was performed to evaluate the prostate-specific membrane antigen (PSMA) expression, which has recently been reported to be a potential biological marker in a variety of tumors including HCC. High PSMA uptake was recorded in both the metastatic bone lesions and the primary liver lesion/tumor by the 68Ga-PSMA PET/CT.

Keywords: Hepatocellular carcinoma, bone metastases, PET/CT, 68Ga-PSMA, 18F-FDG

Ethics

Informed Consent: Informed consent was taken.

Peer-review: Externally and internally peer-reviewed.

Authorship Contributions

Concept: S.E., Design: S.E., Data Collection or Processing: S.E., N.A., Analysis or Interpretation: S.E., N.A., Literature Search: S.E., Writing: S.E.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.

Images

  1. Sacks A, Peller PJ, Surasi DS, Chatburn L, Mercier G, Subramaniam RM. Value of PET/CT in the management of primary hepatobiliary tumors, part 2. AJR Am J Roentgenol 2011;197:260-265.
  2. Afshar-Oromieh A, Avtzi E, Giesel FL, Holland-Letz T, Linhart HG, Eder M, Eisenhut M, Boxler S, Hadaschik BA, Kratochwill C, Weichert W, Kopka K, Debus J, Haberkorn U. The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging 2015;42:197-209.
  3. Erhamamci S, Aslan N. Primary Hepatocellular Carcinoma With Intense 68Ga-PSMA Uptake But Slight 18F-FDG Uptake on PET/CT Imaging Clin Nucl Med 2020; 45:e176-e177.
  4. Perez PM, Flavell RR, Kelley RK, Umetsu S, Behr SC. Heterogeneous Uptake of 18F-FDG and 68Ga-PSMA-11 in Hepatocellular Carcinoma. Clin Nucl Med 2019;44:e133-e135.
  5. Taneja S, Taneja R, Kashyap V, Jha A, Jena A. 68Ga-PSMA Uptake in Hepatocellular Carcinoma. Clin Nucl Med 2017;42:e69-e70.
  6. Sasikumar A, Joy A, Nanabala R, Pillai MRA, Thomas B, Vikraman KR. 68Ga-PSMA PET/CT imaging in primary hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 2016;43:795-796.
  7. Kesler M, Levine C, Hershkovitz D, Mishani E, Menachem Y, Lerman H, Zohar Y, Shibolet O, Even-Sapir E. 68Ga-labeled prostate-specific membrane antigen is a novel PET/CT tracer for imaging of hepatocellular carcinoma: a prospective pilot study. J Nucl Med 2019;60:185-191.
  8. Kuyumcu S, Has-Simsek D, Iliaz R, Sanli Y, Buyukkaya F, Akyuz F, Turkmen C. Evidence of Prostate-Specific Membrane Antigen Expression in Hepatocellular Carcinoma Using 68Ga-PSMA PET/CT. Clin Nucl Med 2019;44:702-706.