Renal cell carcinoma with local tumor extension and pulmonary tumor embolism captured on hybrid CT and F18-PSMA PET

Figures

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  Fig 1. Contrast-enhanced CT and 18F-DCFPyL PSMA PET-CT images. Contrast-enhanced axial CT images (A, C) demonstrate filling defects in the right lung middle lobar and lower lobar arteries (A, red arrow), the left lung basal segmental arteries (A, red arrow) and infrahepatic IVC (C, black arrow). Axial fused 18F-DCFPyL PSMA PET/CT images (B, D) demonstrate moderate-intense PSMA radiotracer expression associated with the thrombus (B, red arrow; D, black arrow). The right renal lower pole mass seen on the contrast-enhanced axial CT (C, white arrow) also demonstrates peripheral PSMA expression with an osteopenic center (D, white arrow), which is in keeping with renal cell carcinoma with central necrosis. The whole-body maximum intensity projection image (E) captures the spatial positioning of the tumor (white arrow) and thrombi (red arrow, black arrow) relative to each other.