[ 68 Ga]Ga-DOTA-FAPI-04 PET/CT imaging in a case of prostate cancer with shoulder arthritis
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[68Ga]Ga-DOTA-FAPI-04 PET/CT imaging in a case of prostate cancer with shoulder arthritis Tingting Xu 1,2,3 & Yan Zhao 1,2,3 & Haoyuan Ding 1,2,3 & Liang Cai 1,2,3 & Zhijun Zhou 1,2,3 & Zhenyu Song 4 & Yue Chen 1,2,3 Received: 6 August 2020 / Accepted: 31 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Fibroblast activation proteins (FAPs) are uniquely expressed at tissue remodelling sites associated with tumours, arthritis, fibrosis, and atherosclerosis [1]. We investigated the usefulness of [68Ga]Ga-DOTA-FAPI-04 PET/CT imaging in a case of prostate cancer with shoulder arthritis. A 76-year-old man presented with headache since a month. He had a history of chronic prostatitis and left shoulder osteoarthritis; his shoulder pain was aggravated by heavy physical activity for the past 2 weeks. Head MRI (a–c) revealed a nodule with surrounding oedema in the left frontotemporal lobe. The nodule showed low signal intensity on TI-weighted imaging (a, arrow) and high signal intensity on T2-weighted imaging (b, arrow); contrast-enhanced MRI (c, arrow) showed circular enhancement of the nodule, indicating a possible brain metastasis. Serum carbohydrate antigen levels (CA724, 27.8 IU/mL and CA199, 54.28 IU/mL) were abnormally high, while the prostate-specific antigen (PSA) level (4.569 ng/mL) was only modestly elevated. The MIP This article is part of the Topical Collection on Image of the month * Yue Chen [email protected] 1
Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou 646000, Sichuan, People’s Republic of China
2
Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou 646000, Sichuan, People’s Republic of China
3
Academician (Expert) Workstation of Sichuan Province, Luzhou, People’s Republic of China
4
Magnetic Resonance Room, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou 646000, Sichuan, People’s Republic of China
(d) of [18F]FDG PET/CT showed abnormal [18F]FDG uptake in the left shoulder (arrowhead) and left prostate (curved arrow). Axial PET/CT showed [18F]FDG activity in the known intracranial lesion (e, thick arrow), left shoulder (f, arrowhead), and left peripheral zone of the prostate (g, curved arrow). The shoulder uptake is indicative of shoulder arthritis, and the prostate lesion is indeterminate (combined with the history of prostatitis and the PSA level). The MIP and axial PET/CT of [68Ga]Ga-DOTA-FAPI-04 showed an abnormal tracer uptake in the intracranial lesion (h–i, thick arrows). An intense [68Ga]Ga-DOTA-FAPI-04 uptake was observed in the left shoulder (h and j, arrowheads), corresponding to the known arthritis. Congruent with [18F]FDG PET/ CT findings, [68Ga]Ga-DOTA-FAPI-04 uptake was also abnormal in the known prostate zone (h and k, curved arrows). No other malignant lesions were noted on [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT. A biopsy of the left posterolateral prostate region confirmed prostate cancer. The pat
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