Prostate-Specific Membrane Antigen-Positive Manifestations of Chronic Beryllium Lung Disease.

Three years after prostatectomy, a 78-year-old man with initial high-risk prostate cancer and new increasing prostate-specific antigen levels underwent Ga-prostate-specific membrane antigen (PSMA) PET/CT. Imaging revealed PSMA-positive pelvic, ascending retroperitoneal and left supraclavicular lymph nodes consistent with metastases. Additionally, there was PSMA-positive lymphadenopathy (hilar and mediastinal) and pulmonary changes (fibrotic and nodular) in which histopathology excluded metastases. A lymphocyte proliferation test was indicative of beryllium sensitization. Chronic beryllium lung disease-a multisystem granulomatous inflammatory disease mainly affecting the lungs-could be established in this patient with occupational exposure to beryllium. This case shows that manifestations of berylliosis can also be PSMA positive.

Influence of fractional anisotropy thresholds on diffusion tensor imaging tractography of the periprostatic neurovascular bundle and selected pelvic tissues: do visualized tracts really represent nerves?

Background Diffusion tensor imaging (DTI) tractography has recently been shown to successfully visualize periprostatic tracts allegedly representing the neurovascular bundle. Purpose To examine the impact of different fractional anisotropy (FA) thresholds on the results of DTI tractography in the male pelvis as well as to evaluate the resulting specificity for nerve tracts. Material and Methods Ten healthy male volunteers were examined at 3 Tesla. DTI tractography was performed based on seed points placed circularly around the prostate, in the rectoprostatic angle, the peripheral zone of the prostate, the sciatic nerve, and in addition the urinary bladder using FA thresholds of 0.20, 0.05, and 0.01. DTI tract number and DTI tract length measured with different FA thresholds were compared. ANOVA with repeated measures was used for statistics. Results DTI tract number and tract length were significantly dependent on FA thresholds. While a FA threshold of 0.20 visualized the typical distribution of DTI tracts in the sciatic nerve, a FA threshold of ≤0.05 was necessary to yield results visually mimicking the distribution of nerve tracts in the NVB. However, with such low FA thresholds even in the filled urinary bladder DTI tracts could be visualized. With FA thresholds of 0.20, the number and length of periprostatic DTI tracts did not differ from those measured within the prostate. Conclusion DTI tractography can be used to visualize DTI tracts periprostatically. However, one may doubt that these DTI tracts represent nerve tracts and that the periprostatic neurovascular bundle can be evaluated in a meaningful way with the current methods available.