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. 2020 Aug 5;20:723. doi: 10.1186/s12885-020-07192-7

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© The Author(s) 2020

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 2 — Example of staging change of PSMA PET/CT compared with conventional imaging. A man presented with a clinical T2c Gleason 7b (predominant Gleason score 4) PCa with an iPSA of 16. Planar BS (a) showed a faint spot in the left proximal femur (red arrow) which was confirmed on SPECT/CT (b) as a sclerotic lesion with osteoblastic activity (red arrow). The lesion was interpreted as suspicious for bone metastasis. Other areas with increased osteoblastic activity (green arrows) were interpreted as degenerative. A [⁶⁸Ga]PSMA PET/CT (c) 36 days later shows a PSMA positive bilateral PCa (blue arrow), but no PSMA expression in the sclerotic lesion in the left proximal femur (d, red arrow). Based on PSMA PET/CT the lesion in the left proximal femur was regarded as not suspicious for bone metastasis; M stage changed from positive to negative and treatment intent changed from palliative to curative