Journal of the Pakistan Medical Association (May 2023)

Tumour sink effect on 68Ga-PMSA PET/CT: A case of diffuse metastatic disease of prostate cancer

  • Sharjeel Usmani,
  • Khulood Al Riyami,
  • Sofiullah Abubakar,
  • Anjali Jain,
  • Asiya Al Busaidi

DOI
https://doi.org/10.47391/JPMA.23-45
Journal volume & issue
Vol. 73, no. 6

Abstract

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68Ga-PMSA imaging has revolutionized both diagnosis and radioligand therapy selection in patients with metastatic prostate cancer. We report a case of a 59-year-old recently diagnosed prostate cancer with high PSA level pf >2000ng/ml referred for 68Ga-PSMA PET/CT. 68Ga-PSMA PET/CT showed diffuse intense tracer uptake throughout the axial and appendicular skeleton with significantly lower uptake of 68Ga-PSMA in normal organs in a configuration of “tumour sink effect”. Findings are in keeping with diffuse skeletal infiltration and suspected marrow infiltration. Given the extensive nature of bone disease and pattern, 177Lu-PSMA-targetted radioligand therapy was thought to be more appropriate in a given situation with a favourable toxicity profile. Keywords: 68Ga-PSMA PET/CT; tumor sink effect; 177Lu-PSMA-RLT; PET/CT

Keywords