PSMA-Avid Desmoid Tumor of the Abdominal Wall on 18F-Piflufolastat PET/CT.

ABSTRACT: Prostate-specific membrane antigen (PSMA) PET/CT is widely used in the evaluation of suspected metastasis for initial definitive therapy and suspected recurrence of prostate cancer. We outline a case report of a 62-year-old man with history of prostate cancer treated with surgery, salvage radiation, and hormonal therapy presenting with rising PSA levels. There was incidental detection of a PSMA-avid subcutaneous abdominal wall mass on PSMA PET/CT study, which was consistent with desmoid fibromatosis on an ultrasound-guided biopsy.

Supraclavicular and Axillary Lymphadenopathy Induced by COVID-19 Vaccination on 18F-Fluorthanatrace, 68Ga-DOTATATE, and 18F-Fluciclovine PET/CT.

ABSTRACT: COVID-19 vaccination has started in most countries, and postvaccination imaging is inevitable in the oncologic population. The immune response to the vaccination in the form of reactive lymphadenopathy has been well documented on 18F-FDG PET/CT. We present the imaging findings of 3 patients who have undergone non-FDG PET/CT imaging including 18F-fluorthanatrace, 68Ga-DOTATATE, and 18F-fluciclovine PET/CT. It is crucial to recognize the timing and laterality of immunization to avoid false-positive findings.

Incidental Detection of Urothelial Carcinoma on 18F-Fluciclovine PET/CT.

ABSTRACT: 18F-Fluciclovine PET/CT has become a common diagnostic imaging study used in the evaluation of biochemical recurrence in prostate cancer since its approval in 2016. We present a case report of an 82-year-old man with history of both prostate and bladder cancer who presented for a fluciclovine study due to rising PSA levels. There was incidental detection of focal penile activity, and a subsequent urethral biopsy performed showed urothelial carcinoma, which was also seen on a subsequent MRI study.

Imaging and Management of Prostate Cancer.

Prostate cancer (PCa) is the most common noncutaneous malignancy in men and the second leading cause of cancer related death in the United States. Men with clinical suspicion of PCa undergo tissue sampling and based on features including the Gleason score, Prostate Specific antigen (PSA) levels and clinical tumor (T) stage, patients are risk stratified into 6 major groups based on National Comprehensive Cancer Network (NCCN) guidelines. This forms the basis for deciding imaging and management. Active surveillance is the preferred approach for less aggressive tumors. Surgery or radiation +/- androgen deprivation therapy continue to be the primary treatment options for localized disease. Imaging plays a critical role in the diagnosis, staging and management of PCa. Multiparametric magnetic resonance imaging (mpMRI) is currently the imaging modality of choice for locoregional staging. MRI, computed tomography and bone scan remain the preferred modalities for evaluation of nodal, soft tissue, and bone metastases, respectively. Advanced positron emission tomography imaging using novel radiotracers are being developed but are not yet integrated in the diagnostic guidelines for initial staging. In this review, we will discuss the imaging and treatment algorithms based on the NCCN risk groups, describe the utility of individual modalities, review Prosate Imaging and Reporting and Data System (PIRADS) version 2.1 for the reporting of mpMRI of the prostate.

Utility of Longitudinal Measurement of the Liver With Ultrasound in Comparison to Computed Tomography Liver Volume in Assessing Hepatomegaly.

ABSTRACT: The purpose of the study is to retrospectively compare the longitudinal measurement of the liver on ultrasound (US) with liver volume as measured on computed tomography (CT). This institutional review board-approved retrospective study with prospective image analysis included adult patients with US examinations of the liver and CT examinations of the abdomen performed within 2 weeks of each other from January 1, 2010, to April 30, 2016. We recorded the dome-to-tip longitudinal length measurement of the right lobe of the liver on the US study. The liver volume was calculated using manual 3-dimensional segmentation of the CT data set. Additional linear liver measurements and qualitative assessments were retrospectively made on the US and CT images. Hepatomegaly was defined as a liver volume 2000 mL or greater. The sample had 302 patients including 140 males and 162 females. Liver length measured on US had a moderate positive correlation with liver volume measured on CT, with a Pearson correlation coefficient of 0.7078. The optimum cutoff of liver length (US) was found to be 17 cm by Youden index, with a sensitivity of 76.0% and specificity of 73.4% for hepatomegaly. Additional linear measurements and qualitative assessments of the liver did not significantly improve the diagnosis of hepatomegaly. In conclusion, liver length measured with US has only a moderate correlation with liver volume. Commonly used US liver length maximum values of 16 to 18 cm produce a significant number of false-negatives and false-positives for the diagnosis of hepatomegaly.