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. Author manuscript; available in PMC: 2019 Mar 1.
Published in final edited form as: Clin Nucl Med. 2018 Mar;43(3):213–216. doi: 10.1097/RLU.0000000000001966

Figure 5.

Figure 5

(A) 18F-DCFPyL PET/CT at baseline and (B) after 10 weeks of therapy in the same man showed no significant radiotracer uptake associated with lymph nodes seen on CT either at baseline or following therapy (pink arrows). Although it has been suggested that exposure to androgen deprivation therapy can increase PSMA expression and radiotracer uptake on PSMA targeted PET/CT, this was not seen here at sites of lymph node disease. Also, literature shows PET detects up-regulation of PSMA in response to androgen deprivation therapy9,10; however the only sites of increasing radiotracer uptake were at sites of osseous flare. Since 18F-DCFPyL uptake can occur at sites of benign osseous disease such as Paget disease11 or metastatic prostate cancer to bone with a predominantly osteoblastic reaction and few viable tumor cells12, in addition to changes in androgen receptor signaling, possible hypotheses for uptake at sites of osseous flare include: neovascularization, cell infiltration from bone repair, or osteoblastic turnover.