{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:48:16Z","timestamp":1792813696422,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bern"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Uncertain focal bone uptake (UBU) with intensive radiopharmaceutical avidity are frequently observed in patients undergoing [<jats:sup>18<\/jats:sup>F]PSMA-1007 PET\/CT for the detection of prostate cancer (PC). Such foci can pose diagnostic conundrums and risk incorrect staging. The aim of this short communication is to share the results of PET-guided biopsies of such foci.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective analysis revealed 10 patients who were referred to our department for PET-guided biopsy of UBU visible in a previous [<jats:sup>18<\/jats:sup>F]PSMA-1007 PET\/CT. [<jats:sup>18<\/jats:sup>F]-PSMA-1007 PET-guided biopsy was conducted for 11 PSMA-avid bone foci in these 10 patients. The biopsy materials were analysed for tissue typing, and immunohistochemistry (IHC) was performed for prostate-specific-membrane-antigen (PSMA) expression. The scans were analysed by two experienced physicians in a consensus read for clinical characteristics and radiopharmaceutical uptake of foci.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One out of 11 (9.1%) of the foci biopsied was confirmed as bone metastasis of PC with intense PSMA-expression, while 10\/11 (90.9%) foci were revealed to be unremarkable bone tissue without evidence of PSMA expression at IHC. Amongst all bone foci assessed by biopsy, eight were visually classified as being at high risk of malignancy in the PET\/CT (SUVmean 12.0\u2009\u00b1\u20098.1; SUVmax 18.8\u2009\u00b1\u200913.1), three as equivocal (SUVmean 4.6\u2009\u00b1\u20092.1; SUVmax 7.2\u2009\u00b1\u20093.0) and zero as low risk. No UBU had any CT correlate.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This cohort biopsy revealed that a small but relevant number of UBU are true metastases. For those confirmed as benign, no PSMA expression at IHC was observed, suggesting a non-PSMA mediated cause for intensive [<jats:sup>18<\/jats:sup>F]PSMA-1007 uptake of which the reason remains unclear. Readers must interpret such foci with caution in order to reduce the risk of erroneous staging and subsequent treatment. PET-guided biopsy, particularly in the absence of morphological changes in the CT, can be a useful method to clarify such foci.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-022-05745-5","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T08:03:14Z","timestamp":1651132994000},"page":"3910-3916","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Assessment of malignancy and PSMA expression of uncertain bone foci in [18F]PSMA-1007 PET\/CT for prostate cancer\u2014a single-centre experience of PET-guided biopsies"],"prefix":"10.1007","volume":"49","author":[{"given":"Bernd","family":"Vollnberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Alberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Genitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Rominger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4492-4243","authenticated-orcid":false,"given":"Ali","family":"Afshar-Oromieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,28]]},"reference":[{"key":"5745_CR1","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1007\/s00259-012-2298-2","volume":"40","author":"A Afshar-Oromieh","year":"2013","unstructured":"Afshar-Oromieh A, Malcher A, Eder M, Eisenhut M, Linhart HG, Hadaschik BA, et al. PET imaging with a [68Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging. 2013;40:486\u201395. https:\/\/doi.org\/10.1007\/s00259-012-2298-2.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7150\/thno.37894","volume":"10","author":"RA Werner","year":"2020","unstructured":"Werner RA, Derlin T, Lapa C, Sheikbahaei S, Higuchi T, Giesel FL, et al. 18F-labeled, PSMA-targeted radiotracers: leveraging the advantages of radiofluorination for prostate cancer molecular imaging. Theranostics. 2020;10:1\u201316. https:\/\/doi.org\/10.7150\/thno.37894.","journal-title":"Theranostics"},{"key":"5745_CR3","doi-asserted-by":"publisher","first-page":"2978","DOI":"10.1007\/s00259-021-05210-9","volume":"48","author":"IL Alberts","year":"2021","unstructured":"Alberts IL, Seide SE, Mingels C, Bohn KP, Shi K, Zacho HD, et al. Comparing the diagnostic performance of radiotracers in recurrent prostate cancer: a systematic review and network meta-analysis. Eur J Nucl Med Mol Imaging. 2021;48:2978\u201389. https:\/\/doi.org\/10.1007\/s00259-021-05210-9.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05456-3","author":"EG Arnfield","year":"2021","unstructured":"Arnfield EG, Thomas PA, Roberts MJ, Pelecanos AM, Ramsay SC, Lin CY, et al. Clinical insignificance of [(18)F]PSMA-1007 avid non-specific bone lesions: a retrospective evaluation. Eur J Nucl Med Mol Imaging. 2021. https:\/\/doi.org\/10.1007\/s00259-021-05456-3.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR5","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05424-x","author":"H Grunig","year":"2021","unstructured":"Grunig H, Maurer A, Thali Y, Kovacs Z, Strobel K, Burger IA, et al. Focal unspecific bone uptake on [(18)F]-PSMA-1007 PET: a multicenter retrospective evaluation of the distribution, frequency, and quantitative parameters of a potential pitfall in prostate cancer imaging. Eur J Nucl Med Mol Imaging. 2021. https:\/\/doi.org\/10.1007\/s00259-021-05424-x.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05620-9","author":"I Alberts","year":"2021","unstructured":"Alberts I, Mingels C, Zacho HD, Lanz S, Schoder H, Rominger A, et al. Comparing the clinical performance and cost efficacy of [(68)Ga]Ga-PSMA-11 and [(18)F]PSMA-1007 in the diagnosis of recurrent prostate cancer: a Markov chain decision analysis. Eur J Nucl Med Mol Imaging. 2021. https:\/\/doi.org\/10.1007\/s00259-021-05620-9.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR7","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05282-7","author":"I Alberts","year":"2021","unstructured":"Alberts I, H\u00fcnermund J-N, Prenosil G, Mingels C, Bohn KP, Viscione M, et al. Clinical performance of long axial field of view PET\/CT: a head-to-head intra-individual comparison of the Biograph Vision Quadra with the Biograph Vision PET\/CT. Eur J Nucl Med Mol Imaging. 2021. https:\/\/doi.org\/10.1007\/s00259-021-05282-7.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR8","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-07870-5","author":"I Alberts","year":"2021","unstructured":"Alberts I, H\u00fcnermund J-N, Sachpekidis C, Mingels C, Fech V, Bohn KP, et al. The influence of digital PET\/CT on diagnostic certainty and interrater reliability in [68Ga]Ga-PSMA-11 PET\/CT for recurrent prostate cancer. Eur Radiol. 2021. https:\/\/doi.org\/10.1007\/s00330-021-07870-5.","journal-title":"Eur Radiol"},{"key":"5745_CR9","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1007\/s00259-019-04630-y","volume":"47","author":"I Alberts","year":"2020","unstructured":"Alberts I, Prenosil G, Sachpekidis C, Weitzel T, Shi K, Rominger A, et al. Digital versus analogue PET in [(68)Ga]Ga-PSMA-11 PET\/CT for recurrent prostate cancer: a matched-pair comparison. Eur J Nucl Med Mol Imaging. 2020;47:614\u201323. https:\/\/doi.org\/10.1007\/s00259-019-04630-y.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR10","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13550-020-00745-8","volume":"11","author":"J Kuten","year":"2021","unstructured":"Kuten J, Dekalo S, Mintz I, Yossepowitch O, Mano R, Even-Sapir E. The significance of equivocal bone findings in staging PSMA imaging in the preoperative setting: validation of the PSMA-RADS version 1.0. EJNMMI Res. 2021;11:3. https:\/\/doi.org\/10.1186\/s13550-020-00745-8.","journal-title":"EJNMMI Res"},{"key":"5745_CR11","doi-asserted-by":"publisher","first-page":"1780","DOI":"10.1007\/s00330-009-1338-1","volume":"19","author":"B Klaeser","year":"2009","unstructured":"Klaeser B, Mueller MD, Schmid RA, Guevara C, Krause T, Wiskirchen J. PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences. Eur Radiol. 2009;19:1780\u20135. https:\/\/doi.org\/10.1007\/s00330-009-1338-1.","journal-title":"Eur Radiol"},{"key":"5745_CR12","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1007\/s00259-019-04552-9","volume":"47","author":"I Alberts","year":"2020","unstructured":"Alberts I, Sachpekidis C, Dijkstra L, Prenosil G, Gourni E, Boxler S, et al. The role of additional late PSMA-ligand PET\/CT in the differentiation between lymph node metastases and ganglia. Eur J Nucl Med Mol Imaging. 2020;47:642\u201351. https:\/\/doi.org\/10.1007\/s00259-019-04552-9.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR13","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1007\/s00259-010-1524-z","volume":"37","author":"B Klaeser","year":"2010","unstructured":"Klaeser B, Wiskirchen J, Wartenberg J, Weitzel T, Schmid RA, Mueller MD, et al. PET\/CT-guided biopsies of metabolically active bone lesions: applications and clinical impact. Eur J Nucl Med Mol Imaging. 2010;37:2027\u201336. https:\/\/doi.org\/10.1007\/s00259-010-1524-z.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR14","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1111\/bju.15152","volume":"126","author":"MY Chen","year":"2020","unstructured":"Chen MY, Franklin A, Yaxley J, Gianduzzo T, McBean R, Wong D, et al. Solitary rib lesions showing prostate-specific membrane antigen (PSMA) uptake in pre-treatment staging (68) Ga-PSMA-11 positron emission tomography scans for men with prostate cancer: benign or malignant? BJU Int. 2020;126:396\u2013401. https:\/\/doi.org\/10.1111\/bju.15152.","journal-title":"BJU Int"},{"key":"5745_CR15","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1007\/s00259-017-3712-6","volume":"44","author":"L De Coster","year":"2017","unstructured":"De Coster L, Sciot R, Everaerts W, Gheysens O, Verscuren R, Deroose CM, et al. Fibrous dysplasia mimicking bone metastasis on (68)GA-PSMA PET\/MRI. Eur J Nucl Med Mol Imaging. 2017;44:1607\u20138. https:\/\/doi.org\/10.1007\/s00259-017-3712-6.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR16","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1001\/jamaoncol.2019.0096","volume":"5","author":"WP Fendler","year":"2019","unstructured":"Fendler WP, Calais J, Eiber M, Flavell RR, Mishoe A, Feng FY, et al. Assessment of 68Ga-PSMA-11 PET accuracy in localizing recurrent prostate cancer: a prospective single-arm clinical trial. JAMA Oncol. 2019;5:856\u201363. https:\/\/doi.org\/10.1001\/jamaoncol.2019.0096.","journal-title":"JAMA Oncol"},{"key":"5745_CR17","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1038\/s41391-019-0194-6","volume":"23","author":"E Witkowska-Patena","year":"2020","unstructured":"Witkowska-Patena E, Gi\u017cewska A, Dziuk M, Mi\u015bko J, Budzy\u0144ska A, Wal\u0119cka-Mazur A. Diagnostic performance of 18F-PSMA-1007 PET\/CT in biochemically relapsed patients with prostate cancer with PSA levels \u2264 2.0 ng\/ml. Prostate Cancer Prostatic Dis. 2020;23:343\u20138. https:\/\/doi.org\/10.1038\/s41391-019-0194-6.","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"5745_CR18","doi-asserted-by":"publisher","first-page":"208","DOI":"10.2967\/jnumed.120.246363","volume":"62","author":"K Sprute","year":"2021","unstructured":"Sprute K, Kramer V, Koerber SA, Meneses M, Fernandez R, Soza-Ried C, et al. Diagnostic accuracy of (18)F-PSMA-1007 PET\/CT imaging for lymph node staging of prostate carcinoma in primary and biochemical recurrence. J Nucl Med: official publication, Society of Nuclear Medicine. 2021;62:208\u201313. https:\/\/doi.org\/10.2967\/jnumed.120.246363.","journal-title":"J Nucl Med: official publication, Society of Nuclear Medicine"},{"key":"5745_CR19","doi-asserted-by":"publisher","first-page":"362","DOI":"10.2967\/jnumed.118.212233","volume":"60","author":"FL Giesel","year":"2019","unstructured":"Giesel FL, Knorr K, Spohn F, Will L, Maurer T, Flechsig P, et al. Detection efficacy of (18)F-PSMA-1007 PET\/CT in 251 patients with biochemical recurrence of prostate cancer after radical prostatectomy. J Nucl Med: official publication, Society of Nuclear Medicine. 2019;60:362\u20138. https:\/\/doi.org\/10.2967\/jnumed.118.212233.","journal-title":"J Nucl Med: official publication, Society of Nuclear Medicine"},{"key":"5745_CR20","doi-asserted-by":"publisher","first-page":"2055","DOI":"10.1007\/s00259-018-4089-x","volume":"45","author":"K Rahbar","year":"2018","unstructured":"Rahbar K, Afshar-Oromieh A, Seifert R, Wagner S, Sch\u00e4fers M, B\u00f6gemann M, et al. Diagnostic performance of (18)F-PSMA-1007 PET\/CT in patients with biochemical recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2018;45:2055\u201361. https:\/\/doi.org\/10.1007\/s00259-018-4089-x.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR21","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.2967\/jnumed.118.222307","volume":"60","author":"NJ Rupp","year":"2019","unstructured":"Rupp NJ, Umbricht CA, Pizzuto DA, Lenggenhager D, Topfer A, Muller J, et al. First Clinicopathologic Evidence of a Non-PSMA-Related Uptake Mechanism for (68)Ga-PSMA-11 in Salivary Glands. J Nucl Med: official publication, Society of Nuclear Medicine. 2019;60:1270\u20136. https:\/\/doi.org\/10.2967\/jnumed.118.222307.","journal-title":"J Nucl Med: official publication, Society of Nuclear Medicine"},{"key":"5745_CR22","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05446-5","author":"VJ Tschan","year":"2021","unstructured":"Tschan VJ, Borgna F, Schibli R, Muller C. Impact of the mouse model and molar amount of injected ligand on the tissue distribution profile of PSMA radioligands. Eur J Nucl Med Mol Imaging. 2021. https:\/\/doi.org\/10.1007\/s00259-021-05446-5.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5745_CR23","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1055\/a-1044-1855","volume":"59","author":"I Alberts","year":"2020","unstructured":"Alberts I, Sachpekidis C, Fech V, Rominger A, Afshar-Oromieh A. PSMA-negative prostate cancer and the continued value of choline-PET\/CT. Nuklearmedizin Nucl Med. 2020;59:33\u20134. https:\/\/doi.org\/10.1055\/a-1044-1855.","journal-title":"Nuklearmedizin Nucl Med"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-022-05745-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-022-05745-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-022-05745-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T07:09:55Z","timestamp":1661238595000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-022-05745-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,28]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["5745"],"URL":"https:\/\/doi.org\/10.1007\/s00259-022-05745-5","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,28]]},"assertion":[{"value":"20 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approval for the publication of these data was given by the local ethics committee ID 2020\u201301162. The study was performed in accordance with the principles enunciated in the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}