Figure 9.
Lesion suggestive of malignancy on anatomic imaging but lacking uptake on PSMA-targeted positron emission tomography (PET)/computed tomography (CT). 68Ga-PSMA-11 PET/CT for restaging in a 52-year-old man with a history of a prostate cancer. Whole-body maximum intensity projection image demonstrating intense radiotracer uptake in metastases in the liver, lymph nodes and bone (A). Axial low-dose CT (B), contrast-enhanced CT (C), PET (D), and fused PET/CT (E) showing a hepatic lesion suggestive of malignancy on anatomic imaging, but lacking uptake (red arrows), consistent with a PSMA-RADS-3D lesion. In addition, there are numerous hepatic lesions with intense tracer uptake, consistent with a classification as PSMA-RADS-5 lesions.