High 18Fluor-DCFPyL Uptake in Adrenal Adenomas

Abstract: Radioisotope-labeled prostate-specific membrane antigen (PSMA) tracers have been proven accurate for detection of prostate cancer localizations. Uptake of those tracers in other malignant and benign lesions has been reported, including faint accumulation of 68Ga-PSMA-HBED-CC in adrenal adenoma. A 77-year-old man with prostate carcinoma was scanned with 18F-DCFPyL, a promising 18F-labeled PSMA ligand, for prostate-specific antigen progression while on luteinizing hormone–releasing hormone agonist therapy. The PET/CT shows 18F-DCFPyL uptake in bilateral enlarged adrenals. Non–contrast-enhanced CT scan indicated left adrenal adenoma. Regarding the high positive predictive value of multiphase contrast-enhanced CT (98%), presence of right adrenal adenoma is also likely.

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