FIGURE 5.

PSMA-RADS-3A: equivocal uptake in several retroperitoneal lymph nodes of patient with rapidly rising level of prostate-specific antigen and no other evidence of disease. Axial CT (A), axial ¹⁸F-DCFPyL PET (B), and axial ¹⁸F-DCFPyL PET/CT (C) images show series of small (short-axis diameter, <0.8 cm) left paraaortic lymph nodes (arrows). Degree of uptake is similar to blood pool, leaving this finding indeterminate. Depending on local practice pattern, biopsy of these nodes may be considered (although biopsy of this site is difficult). Follow-up imaging in 3–6 mo may also be considered.