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[18F]PSMA-1007 has primarily hepatobiliary excretion and it is suggested to use spleen as reference tissue instead of liver. The aim of this study is to investigate the normal range and interpatient variability of [18F]PSMA-1007 uptake in reference tissue for prostate cancer patients, with particular focus on the splenic uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A total of 102 [18F]PSMA-1007 PET\/CT scans of prostate cancer patients with biochemical recurrence (BCR) from three hospitals were included in the analysis. SUV\n                      <jats:sub>max<\/jats:sub>\n                      and SUV\n                      <jats:sub>mean<\/jats:sub>\n                      measurements were performed in the blood pool, liver, spleen, and parotid glands. Results are reported as median with percentiles [5th, 95th].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For 15\/102 (15%) and 20\/102 (20%) of the patients, the SUV\n                      <jats:sub>max<\/jats:sub>\n                      and SUV\n                      <jats:sub>mean<\/jats:sub>\n                      , respectively, were higher in the spleen than in the parotid glands. Median SUV\n                      <jats:sub>max<\/jats:sub>\n                      of the reference tissues were 1.2 [0.6, 2.2] for blood, 15.8 [8.9, 26.2] for spleen, and 26.6 [14.5, 40.4] for the parotid glands. Median SUV\n                      <jats:sub>mean<\/jats:sub>\n                      were 11.9 [6.6, 20.7] for spleen and 19.3 [11.2, 32.1] for the parotid glands.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this multicenter cohort of BCR patients, [18F]PSMA-1007 reference tissue uptake is reported in accordance with the PROMISE protocol. A substantial number of patients present with higher uptake in the spleen than in parotid glands, for reasons that are currently unexplained. Care should be taken when interpreting these values until further studies are conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>The normal range for [18F]PSMA-1007 uptake values in PROMISE reference tissues are not well documented, challenging standardized lesion categorization in prostate cancer PET interpretation<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>In a multicenter cohort, splenic [18F]PSMA-1007 uptake exceeded parotid gland uptake in a notable subgroup (15%), leading to situations where PSMA expression scoring according to the PROMISE framework cannot be applied as intended<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Unexpectedly high splenic uptake relative to parotid gland uptake of [18F]PSMA-1007 in some patients may affect lesion categorization; careful interpretation is advised<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12496-6","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T17:59:52Z","timestamp":1776967192000},"page":"6810-6819","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reference tissue uptake of [18F]PSMA-1007 in positron emission tomography of recurrent prostate cancer"],"prefix":"10.1007","volume":"36","author":[{"given":"Bendik Skarre","family":"Abrahamsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-2878","authenticated-orcid":false,"given":"Ingerid Skjei","family":"Knudtsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Julius","family":"Tulipan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eivor","family":"Hernes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond Velde","family":"Bogsrud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten Margrete","family":"Seln\u00e6s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kon","family":"Johansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tone Frost","family":"Bathen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattijs","family":"Elschot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"12496_CR1","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1007\/s00259-017-3725-1","volume":"44","author":"S Fanti","year":"2017","unstructured":"Fanti S, Minozzi S, Morigi JJ et al (2017) Development of standardized image interpretation for 68Ga-PSMA PET\/CT to detect prostate cancer recurrent lesions. 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Ethical approval was given by the Regional Committees for Medical and Health Research Ethics (REC). For the retrospective cohort, REC waived the need for signed informed consents (REC 10473), while for the prospective cohort, signed informed consents were collected for all patients (REC 83009).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent and ethical approval"}},{"value":"The retrospective cohort has been previously reported in the added value of [18F]PSMA-1007 PET\/CT and PET\/MRI in patients with biochemically recurrent prostate cancer: impact on detection rates and clinical management. J Magn Reson Imaging 61:466\u2013477.\n                      \n                      . The abstract of this work was and is available pre-publication at:\n                      \n                      .","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study objects or cohorts overlap"}}]}}