Intra-patient tumor heterogeneity makes tissue sampling of the most appropriate index lesion challenging. (IMAGE)

Society of Nuclear Medicine and Molecular Imaging

Intra-patient tumor heterogeneity makes tissue sampling of the most appropriate index lesion challenging.

Caption

Intra-patient tumor heterogeneity makes tissue sampling of the most appropriate index lesion challenging. (A) Baseline PSMA PET/CT demonstrated group of 3 lymph nodes with homogeneously intense uptake with SUVs of 29.7-35.5 (arrows). (B) After 225Ac-PSMA therapy, 2 lesions with SUVs of 29.7 and 32.0 showed morphologic response (green arrows), but index lesion with highest initial uptake (SUV, 35.5) had increased size (red arrow) and persisting PSMA uptake (SUV, 30.0). (C) This lesion (encircled) was chosen for imaging-guided biopsy.

Credit

Images created by C Kratochwil and CP Heussel et al., University Hospital Heidelberg, Germany.

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