PET imaging using radiotracers that target prostate-specific membrane antigen (PSMA) are increasingly being used in the evaluation of men with prostate cancer (PCa). It is therefore of increasing importance for imaging specialists to recognize potential pitfalls of this novel imaging technique. In this report, we describe a series of benign elastofibroma dorsi with uptake of the PSMA-targeted PET radiotracer 18F-DCFPyL.Patients and methods
We retrospectively analyzed the imaging data of 75 men with PCa who were consecutively imaged with 18F-DCFPyL PET/CT. Acquired images were reviewed for the presence of radiotracer uptake in the region of the scapular tip adjacent to the chest wall. Only those lesions with discrete radiotracer uptake corresponding to an area on CT with the characteristic appearance of an elastofibroma were considered positive.Results
In total, 18/75 (24.0%) patients had evidence of at least one elastofibroma dorsi on 18F-DCFPyL PET/CT. Eight (44.4%) of these patients had unilateral lesions, all of which were right sided. Detected lesions had a median maximal diameter of 2.3 cm (range: 1.3–8.4 cm) and a median perpendicular thickness to the chest wall of 0.9 cm (range: 0.6–2.5 cm). The median maximum standardized uptake value of detected lesions was 1.4 (range: 1.1–2.4) and the median maximum standardized uptake value corrected to lean body mass was 1.1 (range: 0.8–1.7).Conclusion
This study is the first to report uptake of a PSMA-targeted PET radiotracer in elastofibroma dorsi. Radiotracer uptake in these benign lesions should not be falsely mistaken as sites of metastatic PCa.