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Technical Pitfall in 68Ga–Prostate Specific Membrane Antigen Imaging: Altered Biodistribution Caused by Free 68Ga-Citrate Due to Radiolysis Showing Increased Vascular Activity

Hod, Nir, MHA, MD; Anconina, Reut, MD; Levin, Daniel, MD; Ezroh Kazap, Dina, MD; Lantsberg, Sophie, MD

doi: 10.1097/RLU.0000000000002087
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As with any new molecular imaging modality, accurate characterization of abnormalities on 68Ga-PSMA PET/CT imaging can be accomplished only if one is aware of the normal distribution pattern, physiological variants, and potential sources of false imaging findings. Altered biodistribution can have a significant impact on scan interpretation. Presented here is a rare case in which radiopharmaceutical radiolysis occurred causing excessive free 68Ga-citrate showing as an increased vascular activity. As 68Ga-PSMA PET/CT imaging is a relatively new imaging technique, it is important to be aware of such a potential technical pitfall in clinical practice in order to prevent scan misinterpretation.

From the Institute of Nuclear Medicine and Molecular Imaging, Soroka University Medical Center, Affiliated to Ben Gurion University of the Negev, Beer-Sheva, Israel.

Received for publication February 27, 2018; accepted March 5, 2018.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Sophie Lantsberg, MD, Institute of Nuclear Medicine and Molecular Imaging, Soroka University Medical Center, POB 151, Beer-Sheva, Israel. E-mail: SophieL@clalit.org.il; or Nir Hod, MHA, MD, Institute of Nuclear Medicine and Molecular Imaging, Soroka University Medical Center, POB 151, Beer-Sheva, Israel. E-mail: hod_n@yahoo.com.

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