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. 2020 Aug 12;48(2):509–520. doi: 10.1007/s00259-020-04974-w

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© The Author(s) 2020

Open Access This 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/.

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Fig. 3 — A 68-year-old man with cT2c, Gleason score 3 + 4 = 7 prostate cancer and initial PSA 10.4 ng/mL considered candidate for radical prostatectomy with extended pelvic lymph-node dissection. MSKCC nomogram showed 10.8% risk of lymph-node involvement. Transversal ¹⁸F-DCFPyL PET (a) and fused PET/CT (b) show intense uptake in the pelvic region right, corresponding with an enlarged 10-mm lymph node adjacent to the right external iliac artery on CT (c), suspect for lymph-node metastasis (a–c, left arrow). A contralateral focus with faint uptake is observed on PET and fused PET/CT in the pelvic region, without an evident morphologic substrate on CT. Due to the minimal tracer uptake (above the blood pool and lower than the liver); this left-sided focus was not suspect for lymph-node metastasis after dual reading. After surgical resection of 26 lymph nodes, post-operative histopathology revealed a right-sided right iliac lymph-node metastasis measuring 10 mm, as well as a left iliac lymph-node metastasis of 5 mm, haematoxylin and eosin stain, original magnification × 10 (d)