We evaluated the incidence and potential etiology of tracheobronchial uptake in patients being evaluated by 18F-DCFPyL PET/CT for prostate cancer (PCa). Methods: The study included a consecutive 100 PCa patients referred for 18F-DCFPyL PET/CT. The PET/CT scans were retrospectively reviewed. The presence or absence of physiologic tracheobronchial uptake on PET/CT was recorded. To further evaluate tracheal prostate-specific membrane antigen (PSMA) expression, immunohistochemistry was performed on tracheal samples taken from 2 men who had surgical resection of lung cancer. Results: Tracheal uptake was present in 31 of 100 patients (31%). When tracheal uptake was present, the SUVmax was significantly higher in the left main bronchus (mean, 2.7) than in the right (mean, 2.3) (P < 0.001). Histopathologic testing of tracheobronchial samples showed PSMA expression in bronchial submucosal glands. Conclusion: In PCa patients undergoing 18F-DCFPyL PET/CT, tracheobronchial uptake occurred in 31% of patients. This is attributed to normal physiologic PSMA expression in bronchial submucosal glands.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2024 Aug 01 [Epub ahead of print]
Medhat M Osman, Amir Iravani, Catherine Mitchell, Rodney J Hicks, Elisa Perry, Michael S Hofman
Department of Radiology, Saint Louis University Hospital, St. Louis, Missouri; ., Department of Radiology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington., Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Melbourne Theranostic Innovation Centre, Melbourne, Victoria, Australia., Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; and.