Patient Information:
	•	Name: ANON
	•	Age: 77 years
	•	Examination Date: 04/02/2025
	•	Physician: ANON
	•	Insurance: Private
	•	Facility: ANON

PET/CT - Positron Emission Tomography Combined with Computed Tomography using PSMA-18F

Technique:
	•	Radiotracer: PSMA-18F
	•	Dose: 5.78 mCi
	•	Uptake Time: 79 minutes
	•	Protocol:
	•	Tomographic images were acquired from the skull to the upper thigh using a dedicated PET/CT scanner after intravenous injection of the radiotracer.
	•	Diagnostic CT images of the same region were obtained with intravenous iodinated contrast.
	•	The study was complemented with CT images of the thorax taken during maximum inspiration.
	•	A venous diuretic (furosemide) was administered before imaging to reduce interference from physiological urinary elimination in pelvic images.

Clinical Context:
	•	Purpose: Oncological staging
	•	Diagnosis: Prostate cancer
	•	Gleason Score: 8 (4+4)
	•	PSA Level: 45.90 ng/mL (as of 09/13/2024)

Findings:

The fusion of molecular (PET) and anatomical (CT) images reveals:

1. Prostate:
	•	Enlarged prostate with heterogeneous texture
	•	Hypermetabolic lesion involving the gland from base to apex, mainly on the left side but crossing the midline
	•	SUVmax: 27.0
	•	Capturing Area: Approximately 7.1 cm³
	•	PRIMARY Score: 5
	•	PSMA Uptake Score: 3

2. Bone Metastasis Suspicion:
	•	Location: Left iliac crest
	•	SUVmax: 4.1
	•	No evident morphological alteration in the corresponding area
	•	Recommendation: Correlation with MRI

Additional Findings from PET/CT:
	•	No other abnormal tracer uptake beyond expected physiological distribution for the patient’s age

CT Findings Without Molecular Expression but Clinically Relevant:
	•	Vascular calcifications, including coronary calcifications
	•	Gallstones
	•	Renal cortical cysts in both kidneys (largest measuring 7.8 cm in the right kidney)
	•	Colonic diverticulosis, predominantly in the sigmoid, without signs of inflammation
	•	Inguinal hernias, with fat and sigmoid colon segment protrusion on the left side

Impression:
	•	The molecular PSMA-expressing finding in the prostate likely represents the primary lesion, with a possible bone metastasis in the left iliac crest, requiring further evaluation with MRI.

Comments:
	1.	The Standardized Uptake Value (SUV) should be interpreted cautiously, as it does not serve as an isolated diagnostic criterion. It should be analyzed in conjunction with clinical and laboratory data. SUV values may vary depending on different equipment and study protocols.
	2.	The CT scan performed as part of PET/CT follows a protocol specific to PET imaging and does not replace a dedicated CT study.