Nuclear Medicine Gozetotide-PET/CT (PSMA-11) Tumor Localization Imaging
EXAM DATE: 3/21/2026 12:23 PM
COMPARISON: None
CORRELATIVE IMAGING: None

CMS CODING: Initial Treatment Strategy

INDICATION: 81 year old Male with rising PSA and biopsy proven prostate
adenocarcinoma. Primary team requests PSMA PET/CT scan to evaluate extent
of disease.

RADIOPHARMACEUTICAL AND TECHNIQUE: 5.36 mCi Ga-68 Gozetotide (PSMA-11) was
injected IV, via a right antecubital vein. There was no report of dose
infiltration or IV problems noted. Patient rested quietly in a dimly lit
room and was allowed to void immediately prior to imaging.

Non-contrast spiral CTs were performed for patient positioning, anatomic
correlation and/or attenuation correction. A 3D PET scan was then acquired
from the skull vertex to the proximal thighs with arms up at 57 minutes
post injection. PET data was reconstructed, attenuation-corrected, and
reformatted into 3 orthogonal planes. Images were reviewed in multiple
softcopy formats, including attenuation-corrected and non-corrected PET,
CT, and fused PET/CT.

RADIATION DOSE:
This study involved (1) CT acquisition(s). The CTDIvol and DLP values are
included below as required by state law:

1; Series: 2; Neck/Abdomen/Pelvis; 32 cm; CTDIvol= 4 mGy; DLP 400.4 mGy-cm

For further information on CT radiation dose, see
http://www.ucdmc.ucdavis.edu/radiology/RadiationDose.html

FINDINGS:
SUVmax activity measured in the units of g/mL unless otherwise stated.
Image numbers reference noncontrast CT unless otherwise stated.

Background blood pool activity measured within the abdominal aorta on image
150 SUVmean is 1.5.
Background activity measured within the liver on image 150 SUVmean is 3.2
Background activity measured within the left parotid gland on image 53
SUVmean is 13.1

Head and Neck:
No abnormal tracer activity identified within the brain. No overt evidence
of mass lesion, midline shift, acute blood by Limited noncontrast CT scan
through the brain.
Physiologic expected tracer activity seen within the bilateral lacrimal
glands, nasal passageways, parotid glands, submandibular glands, vocal
cords.
Thyroid appears normal in size and configuration.
Atherosclerotic calcifications noted within the bilateral carotid arteries.
No overt abnormal enlarged and/or radiotracer avid cervical lymph nodes
identified.
Maxillary sinuses and mastoid air cells are well pneumatized.

Chest:
No overt abnormal enlarged and/or radiotracer avid axillary lymph nodes
identified.
No overt abnormal enlarged and/or radiotracer avid central mediastinal
lymph nodes identified.
Dilated ascending aorta measuring upwards of 4.1 cm.
Atherosclerotic calcifications of the coronary vessels noted.
Few scattered micronodules seen within the lung periphery which are below
levels of detectability by PET/CT.
Dependent atelectatic changes seen within the lung bases.

Abdomen and Pelvis:
Physiologic expected tracer activity identified within the liver.
Gallbladder is unremarkable.
Physiologic expected tracer activity identified within the spleen.
Bilateral adrenal glands are unremarkable.
No abnormal tracer activity identified within the pancreas.
Physiologic tracer activity identified within the bilateral kidneys.
Expected tracer activity identified within the proximal small bowel.
Intense tracer activity identified within majority of the prostate gland
with more dominant activity on the right of the prostate best seen on image
250 with SUV max 30.1.
On image 239 punctate tracer activity identified within the right
perirectal space which appears to correlate with a 0.3 cm lymph node with
SUV max 2.2.
No additional overt abnormal enlarged and/or radiotracer avid upper
abdominal, retroperitoneal or pelvic lymph nodes identified

Musculoskeletal:
Age-appropriate degenerative changes within the vertebral bodies and spine

IMPRESSION:
1. Intense tracer activity identified within the majority of the
prostate with dominant amount on the right greater than left side
compatible with biopsy-proven prostate adenocarcinoma.

2. Punctate tracer activity identified within the right perirectal
space which appears to correlate with a 0.3 cm presumed lymph node. This
may represent local lymph node metastasis.

Note: The non-contrast CT components of this scan were optimized for PET
technique. The CT scans are used for anatomic correlation and/or
attenuation correction; but are not intended to substitute for a dedicated
CT scan.

Final Report Electronically Signed By: Cameron Foster, M.D. on 3/26/2026
4:18 PM