case_images: PMC11199518_01
case_images: Histologic examination of the prostate and liver lesion. Hematoxylin and eosin (H&E) staining (A) revealed prostatic adenocarcinoma, with prostate tumor cells positive for P504S (B). H&E staining (C) shows liver cholangiocarcinoma, with liver tumor cells positive for CK7 (D) and negative for PSA (E) and P504S (F).
case_images: fonc-14-1408453-g001.jpg
case_images: PMC11199518_01_fonc-14-1408453-g001.jpg
case_images: f1
case_images: Histopathological examination revealed prostatic adenocarcinoma with a Gleason score of 6 (3 + 3) ( Figure 1A ). Figure 1B ). For preoperative staging, 18F-PSMA-1007 PET/MR imaging was performed. Histopathological examination of the lesion revealed a moderately to poorly differentiated cholangiocarcinoma ( Figure 1C ); further, the tumor cells were positive for CK7 ( Figure 1D ) and negative for PSA ( Figure 1E ) and P504S ( Figure 1F ).
case_images: Prostate biopsy conducted in a 71-year-old man owing to high PSA level (5.54 ng/ml) and difficult, frequent, and urgent urination. The pathological result showed acinar adenocarcinoma, and the Gleason score was 6. 18F-PSMA-1007 PET/MRI imaging was performed for initial staging. The scan [(A) MIP image; (B) axial T2WI-MRI; (C) axial PET and (D) fused axial PET/MRI] shows high PSMA uptake in the bilateral peripheral zone of the prostate (SUVmax was 5.53). The 18F-FDG PET/MRI scan [(E) axial T2WI-MRI; (F) axial PET; (G) fused axial PET/MRI and (H) MIP image] shows no abnormal radiotracer concentration in prostate. The red arrow indicates the prostate.
case_images: fonc-14-1408453-g002.jpg
case_images: PMC11199518_01_fonc-14-1408453-g002.jpg
case_images: f2
case_images: Whole-body PSMA-PET revealed diffuse increased uptake in the prostate (maximum standard uptake value [SUVmax]=5.53) ( Figures 2A, C, D ). T2-weighted MR revealed an area of low signal intensity in the bilateral peripheral zone and heterogeneous signal intensity in the transitional and central zones ( Figure 2B ). To further determine the nature of liver lesions, 18F-FDG PET/MRI was performed. The prostate showed no FDG uptake ( Figures 2E-H ). The liver lesion had a low FDG uptake with an SUVmax of 3.23 ( Figures 3D-F ).
case_images: 18F-PSMA-1007 PET/MRI [(A) axial T2WI-MRI; (B) axial PET and (C) fused axial PET/MRI] shows a high PSMA uptake mass in the liver (SUVmax=18.76). In 18F-FDG PET/MRI imaging [(D) axial T2WI-MRI; (E) axial PET and (F) fused axial PET/MRI], mild uptake is seen. Contrast-enhanced MRI of the abdomen [(G) T1WI-MRI; (H) arterial phase T1WI-MRI and (I) portal phase T1WI-MRI] reveals a significantly enhanced margin of mass in arterial phase, with further enhancement in the portal phase. The center of the mass is a necrotic area with no enhancement or radiotracer uptake. Postoperative pathology indicates a moderate to poor differential cholangiocarcinoma. The red arrow shows the liver lesion.
case_images: fonc-14-1408453-g003.jpg
case_images: PMC11199518_01_fonc-14-1408453-g003.jpg
case_images: f3
case_images: In addition to the prostate lesions, PSMA-PET imaging showed abnormally increased radiotracer uptake in the liver mass (SUVmax=18.76) ( Figures 3B, C ). T2-weighted images ( Figure 3A ). To further determine the nature of liver lesions, 18F-FDG PET/MRI was performed. The prostate showed no FDG uptake ( Figures 2E-H ). The liver lesion had a low FDG uptake with an SUVmax of 3.23 ( Figures 3D-F ). The center of the mass was a necrotic area with no enhancement or radiotracer uptake ( Figures 3B, G-I ).