Wk 5, Case 5 - Review

Please note: Items with dashed lines (--) are information withheld as it is not relevant for you to arrive at the correct findings and impression for the report and/or it was withheld for privacy information. The items were left in to show you the typical information documented in a PET report.

Clinical Indication:
---- year-old male with history of metastatic hormone sensitive prostate cancer, status post radical prostatectomy, presenting for evaluation for treatment planning.
PSA levels:
40.6 ng/mL on 2/2/2022
28 ng/mL on 4/6/2022
25.1 ng/mL on 5/18/2020.

Technique:
Radiopharmaceutical: 10.2 mCi of F-18 piflufolastat (PSMA, Pylarify) administered IV at ----- at ---.
Incubation interval: -- minutes.
Oral contrast: ----.
Positioning: Arms raised.
PET/CT scanner: -----.
PET/CT acquisition: Vertex-to-mid-thighs.
Standardized uptake value (SUV): Corrected for ----.
CT: Low-dose, non-breath-hold, without intravenous contrast.
TOTAL DLP (Dose Length Product): ---mGy.cm mGy cm.

Comparison/Correlation:
--

Findings:
Technical quality: ----.
Measurements: Unless otherwise specified, all SUVs refer to maximum value in the target.
CT linear measurements performed on axial images.


Head/nNeck:
No suspicious PSMA-avid foci within the head and neck.
No suspicious PSMA-avid or pathologically enlarged cervical lymph nodes.
Unremarkable thyroid gland.


Chest:
No suspicious PSMA-avid foci within the chest.
No suspicious PSMA-avid hilar or mediastinal lymph nodes.
No pericardial or pleural effusions.
No pulmonary masses or suspicious nodules.
Aortic and coronary calcifications.


Abdomen & Pelvis:
No suspicious PSMA-avid foci within the abdomen and pelvis.
No suspicious PSMA-avid retroperitoneal or pelvic lymph nodes.
No suspicious PSMA-avidity in the prostatectomy bed.
Multiple small hypoattenuating hepatic lesions, the larger ones are photopenic, and none are showing significant PSMA uptake above parenchymal level, likely cysts.
Otherwise, unremarkable liver, spleen, gallbladder, pancreas, adrenal and kidneys.
There is no ascites.


Musculoskeletal:
Numerous intensely PSMA-avid sclerotic lesions scattered throughout the axial and proximal appendicular skeleton. Index lesions are:

Intensely PSMA avid osteoblastic foci in the vertebral bodies of T10 with max SUV of 17.9.
Intensely PSMA avid sclerotic lesion involving the vertebral body of T5 with max SUV of 17.5.
Intensely PSMA avid osteoblastic lesion in the manubrium sterni with max SUV of 14.5.
Left sacroiliac joint osteoblastic focus with max SUV of 17.9.

Impression:
1. Numerous intensely PSMA avid metastatic sclerotic lesions scattered throughout the axial and proximal appendicular skeleton.
2. No evidence of PSMA avid nodal or visceral metastases.