| Title |
Tracer uptake in mediastinal and paraaortal thoracic lymph nodes as a potential pitfall in image interpretation of PSMA ligand PET/CT
|
|---|---|
| Published in |
European Journal of Nuclear Medicine and Molecular Imaging, March 2018
|
| DOI | 10.1007/s00259-018-3965-8 |
| Pubmed ID | |
| Authors |
Ali Afshar-Oromieh, Lars Peter Sattler, Katja Steiger, Tim Holland-Letz, Marcelo Livorsi da Cunha, Walter Mier, Oliver Neels, Klaus Kopka, Wilko Weichert, Uwe Haberkorn |
| Abstract |
Since the introduction of68Ga-PSMA-11 PET/CT for imaging prostate cancer (PC) we have frequently observed mediastinal lymph nodes (LN) showing tracer uptake despite being classified as benign. The aim of this evaluation was to further analyze such LN. Two patient groups with biphasic68Ga-PSMA-11 PET/CT at 1 h and 3 h p.i. were included in this retrospective evaluation. Group A (n = 38) included patients without LN metastases, and group B (n = 43) patients with LN metastases of PC. SUV of mediastinal/paraaortal LN of group A (n = 100) were compared to SUV of LN metastases of group B (n = 91). Additionally, 22 randomly selected mediastinal and paraaortal LN of patients without PC were immunohistochemically (IHC) analyzed for PSMA expression. In group A, 7/38 patients (18.4%) presented with at least one PSMA-positive mediastinal LN at 1 h p.i. and 3/38 (7.9%) positive LN at 3 h p.i. with a SUVmax of 2.3 ± 0.7 at 1 h p.i. (2.0 ± 0.7 at 3 h p.i.). A total of 11 PSMA-positive mediastinal/paraaortal LN were detected in nine patients considering both imaging timing points. SUVmax of LN-metastases was 12.5 ± 13.2 at 1 h p.i. (15.8 ± 17.0 at 3 h p.i.). SUVmax increased clearly (> 10%) between 1 h and 3 h p.i. in 76.9% of the LN metastases, and decreased significantly in 72.7% of the mediastinal/paraaortal LN. By IHC, PSMA-expression was observed in intranodal vascular endothelia of all investigated LN groups and to differing degrees within germinal centers of 15/22 of them (68.1%). Expression was stronger in mediastinal nodes (p = 0.038) and when follicular hyperplasia was present (p = 0.050). PSMA-positive mediastinal/paraaortal benign LN were visible in a notable proportion of patients. PSMA-positivity on the histopathological level was associated with the activation state of the LN. However, in contrast to LN metastases of PC, they presented with significantly lower uptake, which, in addition, usually decreased over time. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 67% |
| Unknown | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
| Scientists | 1 | 33% |
| Members of the public | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 29 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 17% |
| Student > Master | 5 | 17% |
| Student > Postgraduate | 3 | 10% |
| Student > Bachelor | 2 | 7% |
| Other | 1 | 3% |
| Other | 3 | 10% |
| Unknown | 10 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 52% |
| Nursing and Health Professions | 1 | 3% |
| Economics, Econometrics and Finance | 1 | 3% |
| Computer Science | 1 | 3% |
| Social Sciences | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 9 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 March 2018.
All research outputs
#14,382,114
of 23,806,312 outputs
Outputs from European Journal of Nuclear Medicine and Molecular Imaging
#1,724
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Outputs of similar age
#180,655
of 332,696 outputs
Outputs of similar age from European Journal of Nuclear Medicine and Molecular Imaging
#23
of 46 outputs
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