Increased PSMA avidity in atherosclerotic hypertensive lesions may relate to active plaque instability or dissecting thrombus, indicating a need for further evaluation.
PSMA uptake in aortic thrombus warrants interpretive caution; case report leaves open its value as instability marker.
An 81-year-old man with prostate adenocarcinoma (Gleason 4 + 3 = 7) treated with brachytherapy and intermittent androgen deprivation therapy was referred for serial Ga-prostate-specific membrane antigen (PSMA-HBED-CC) PET/CT scans for rising prostate-specific antigen. Findings were suggestive of local prostatic recurrence and nodal metastases. An incidental PSMA-avid focus was noted in the anterior wall of an infrarenal aortic aneurysm, with a contrast-enhanced hyperdense region surrounded by a semilunar hypodense region anteriorly, consistent with enlarging dissecting thrombus. Increased PSMA avidity in atherosclerotic hypertensive lesions may relate to active plaque instability, indicating a need for further evaluation.
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Wong et al. (2020) studied this question.
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