{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:25:51Z","timestamp":1785446751660,"version":"3.56.0"},"reference-count":68,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Prostate cancer (PCa) is a high-prevalence disease usually characterized by metastatic spread to the pelvic lymph nodes and bones and the development of visceral metastases only in the late stages of disease. Positron Emission Tomography (PET) plays a key role in the detection of PCa metastases. Several PET radiotracers are used in PCa patients according to the stage and pathological features of the disease, in particular 68Ga\/18F-prostate-specific membrane antigen (PSMA) ligands. Moreover, 2-deoxy-2-[18F]fluoro-D-glucose 18F-FDG PET usually shows metastases in the late stages of disease, when dedifferentiated neoplastic clones lose PSMA expression. In some cases, PCa patients may present atypical sites of metastases, with uncommon appearance at PET imaging with different radiotracers. We present the case of a patient with biochemical recurrence of PCa (ISUP Grade Group IV; PSA 4.7 ng\/mL) showing atypical sites of metastases (the testis and multiple lung nodules) with absent PSMA expression and high [18F]FDG avidity. The patient showed diffuse positivity to alpha-methylacyl-coenzyme A racemase (AMACR). Moreover, a literature review was performed by collecting cases of PCa patients with atypical metastatic spread detected via PET imaging, with the aim of highlighting the relationship between atypical sites of metastases, imaging presentation, and pathology findings.<\/jats:p>","DOI":"10.3390\/biom15010017","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T19:33:07Z","timestamp":1735241587000},"page":"17","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma"],"prefix":"10.3390","volume":"15","author":[{"given":"Ilham","family":"Badrane","sequence":"first","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy"},{"name":"Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Castello","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Department of Pathology and Diagnostic Health, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5117-804X","authenticated-orcid":false,"given":"Corrado","family":"Cittanti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy"},{"name":"Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Adamantiadis","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy"},{"name":"Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Bagni","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Mindicini","sequence":"additional","affiliation":[{"name":"Oncology Unit, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Lancia","sequence":"additional","affiliation":[{"name":"Oncology Unit, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9217-3456","authenticated-orcid":false,"given":"Massimo","family":"Castellani","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1490-0718","authenticated-orcid":false,"given":"Licia","family":"Uccelli","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy"},{"name":"Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"Bartolomei","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-3898","authenticated-orcid":false,"given":"Luca","family":"Urso","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy"},{"name":"Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer Statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","first-page":"1288","article-title":"NCCN Guidelines\u00ae Insights: Prostate Cancer, Version 1.2023","volume":"20","author":"Schaeffer","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.juro.2017.11.095","article-title":"Clinically Localized Prostate Cancer: AUA\/ASTRO\/SUO Guideline. Part I: Risk Stratification, Shared Decision Making, and Care Options","volume":"199","author":"Sanda","year":"2018","journal-title":"J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1056\/NEJMoa1615869","article-title":"Follow-up of Prostatectomy versus Observation for Early Prostate Cancer","volume":"377","author":"Wilt","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1056\/NEJMoa1607529","article-title":"Radiation with or without Antiandrogen Therapy in Recurrent Prostate Cancer","volume":"376","author":"Shipley","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1038\/nrc2351","article-title":"Prostate-Specific Antigen and Prostate Cancer: Prediction, Detection and Monitoring","volume":"8","author":"Lilja","year":"2008","journal-title":"Nat. Rev. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1001\/jama.281.17.1591","article-title":"Natural History of Progression after PSA Elevation Following Radical Prostatectomy","volume":"281","author":"Pound","year":"1999","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s40336-023-00547-7","article-title":"Clinical Applications of Long Axial Field-of-View PET\/CT Scanners in Oncology","volume":"11","author":"Urso","year":"2023","journal-title":"Clin. Transl. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1001\/jamaoncol.2019.0096","article-title":"Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer: A Prospective Single-Arm Clinical Trial","volume":"5","author":"Fendler","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/S1470-2045(19)30415-2","article-title":"18F-Fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in Patients with Early Biochemical Recurrence after Prostatectomy: A Prospective, Single-Centre, Single-Arm, Comparative Imaging Trial","volume":"20","author":"Calais","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1007\/s00259-020-05160-8","article-title":"Prognostic Implications of Dual Tracer PET\/CT: PSMA Ligand and [18F]FDG PET\/CT in Patients Undergoing [177Lu]PSMA Radioligand Therapy","volume":"48","author":"Michalski","year":"2021","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.2967\/jnumed.124.268020","article-title":"Intrapatient Intermetastatic Heterogeneity Determined by Triple-Tracer PET Imaging in mCRPC Patients and Correlation to Survival: The 3TMPO Cohort Study","volume":"65","author":"Pouliot","year":"2024","journal-title":"J. Nucl. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Urso, L., Filippi, L., Castello, A., Marzola, M.C., Bartolomei, M., Cittanti, C., Florimonte, L., Castellani, M., Zucali, P., and Bruni, A. (2023). PSMA PET\/CT in Castration-Resistant Prostate Cancer: Myth or Reality?. J. Clin. Med., 12.","DOI":"10.3390\/jcm12227130"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3667","DOI":"10.1002\/cncr.32957","article-title":"Patterns of Metastases of Prostatic Ductal Adenocarcinoma","volume":"126","author":"Ranasinghe","year":"2020","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1590\/s1677-5538.ibju.2020.0069","article-title":"Atypical Metastases from Prostate Cancer Detected on 68Ga-PSMA PET\/CT: A Case Series","volume":"47","author":"Yamaga","year":"2021","journal-title":"Int. Braz. J. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/1754-9485.13052","article-title":"Prostate Penile Metastasis: Incidence and Imaging Pattern on 68 Ga-PSMA PET\/CT","volume":"64","author":"Tatkovic","year":"2020","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4274\/mirt.galenos.2021.41033","article-title":"Unexpected Metastatic Localizations of Prostate Cancer Determined by 68Ga PSMA PET\/CT: Series of Four Cases","volume":"31","author":"Sezgin","year":"2022","journal-title":"Mol. Imaging Radionucl. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1097\/RLU.0000000000004731","article-title":"Unusual Case of Missed Penile Metastases on 68 Ga-PSMA PET\/CT","volume":"48","author":"Caputo","year":"2023","journal-title":"Clin. Nucl. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1097\/RLU.0000000000002527","article-title":"Uncommon Penio-Scrotal Metastases of Prostate Cancer Detected on 68Ga PSMA PET\/CT","volume":"44","author":"Seniaray","year":"2019","journal-title":"Clin. Nucl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4103\/wjnm.WJNM_39_20","article-title":"Oligometastasis to Testis in Prostate Cancer: Role of Gallium-68 Prostate-Specific Membrane Antigen Positron-Emission Tomography Computed Tomography","volume":"20","author":"Gupta","year":"2021","journal-title":"World J. Nucl. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/RLU.0000000000002843","article-title":"Detection of Unusual Peritoneal Metastases of Prostate Cancer With 68Ga\u2013Prostate-Specific Membrane Antigen PET\/CT","volume":"45","author":"Simsek","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1097\/RLU.0000000000004805","article-title":"68Ga-PSMA-11 PET\/CT in a Case of Isolated Parietal Peritoneal Metastasis From Prostate Adenocarcinoma","volume":"48","author":"Zhao","year":"2023","journal-title":"Clin. Nucl. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/RLU.0000000000002362","article-title":"68Ga-PSMA PET\/CT Urachus Metastases in Recurrent Prostate Cancer With Very Low PSA Level","volume":"44","author":"Rusu","year":"2019","journal-title":"Clin. Nucl. Med."},{"key":"ref_24","first-page":"261","article-title":"Peritoneal Carcinomatosis and Occult Metastasis in Prostate Cancer: [68Ga]PSMA vs [11C]Choline","volume":"40","author":"Castello","year":"2021","journal-title":"Rev. Espa\u00f1ola De Med. Nucl. E Imagen Mol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.5301\/tj.5000260","article-title":"Use of 18F-Choline Positron Emission Tomography\/CT in High-Risk Prostate Cancer: A Case of Solitary Adrenal Metastasis","volume":"101","author":"Matrone","year":"2015","journal-title":"Tumori J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1055\/s-0044-1786012","article-title":"The Role of 68Ga PSMA Imaging in Evaluating Adrenal Lesions in Prostate Cancer Patients","volume":"23","author":"Korkmaz","year":"2024","journal-title":"World J. Nucl. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4274\/mirt.galenos.2023.13471","article-title":"Atypical Presentation of Metastatic Castrate-Resistant Prostate Cancer in a Middle Aged African Male with Good Response to Radioligand Therapy","volume":"33","author":"Evbuomwan","year":"2024","journal-title":"Mirt"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1097\/RLU.0000000000003759","article-title":"68Ga-PSMA-11 PET\/CT in Isolated Bilateral Adrenal Metastases From Prostate Adenocarcinoma","volume":"47","author":"Zhao","year":"2022","journal-title":"Clin. Nucl. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e506","DOI":"10.1097\/RLU.0000000000004795","article-title":"Prostate Adenocarcinoma Metastasis to the Rectal Submucosa and Mesorectal Lymph Node on 18 F-PSMA PET\/CT","volume":"48","author":"Segal","year":"2023","journal-title":"Clin. Nucl. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1007\/s00120-016-0169-3","article-title":"Rektummukosametastase beim Prostatakarzinomrezidiv: 68Ga-PSMA-PET\/CT erm\u00f6glicht eine gezielte Salvagestrahlentherapie","volume":"55","author":"Westenfelder","year":"2016","journal-title":"Urologe"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/RLU.0b013e3182291d1a","article-title":"FDG PET\/CT Demonstration of Pancreatic Metastasis From Prostate Cancer","volume":"36","author":"Desai","year":"2011","journal-title":"Clin. Nucl. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/RLU.0000000000004465","article-title":"Isolated Liver Metastasis Detected by 68 Ga-PSMA PET\/CT in Newly Diagnosed Prostate Cancer","volume":"48","author":"Yilmaz","year":"2023","journal-title":"Clin. Nucl. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e388","DOI":"10.1097\/RLU.0000000000001703","article-title":"68Ga-PSMA PET\/MR\u2013Positive Peritoneal Metastasis in the Falciform Ligament in Recurrent Prostate Cancer","volume":"42","author":"Tran","year":"2017","journal-title":"Clin. Nucl. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s13139-023-00801-w","article-title":"Perirenal Fascia\u2014An Uncommon Site of Metastases in Prostate Cancer Detected on 68Ga-PSMA-11 PET\/CT","volume":"57","author":"Chandekar","year":"2023","journal-title":"Nucl. Med. Mol. Imaging"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Panareo, S., Urso, L., Santi, I., Rigolin, G.M., Cuneo, A., Cittanti, C., and Bartolomei, M. (2020). Right Atrium Mass Assessed with 18F-FDG PET\/CT Scan Turns Out to Be an Uncommon Relapse of Testicular Diffuse Large B-Cell Lymphoma: A Case Report. Diagnostics, 10.","DOI":"10.3390\/diagnostics10110987"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/RLU.0000000000005388","article-title":"A Rare Atypical Intrapericardial Prostate Adenocarcinoma Metastasis with 68Ga-PSMA-11 PET\/CT","volume":"49","author":"Moreau","year":"2024","journal-title":"Clin. Nucl. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Gandini, A., Bauckneht, M., Sofia, L., Tomasello, L., Fornarini, G., and Zanardi, E. (2023). Cardiac Metastasis from Prostate Cancer: A Case Study Underlying the Crucial Role of the PSMA PET\/CT. Diagnostics, 13.","DOI":"10.3390\/diagnostics13172733"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3952","DOI":"10.1007\/s00259-022-05815-8","article-title":"Prostate Cancer Cardiac Metastasis Detected on Serial Imaging with [68Ga] PSMA-11 PET\/CT","volume":"49","author":"Das","year":"2022","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1097\/RLU.0000000000002367","article-title":"Intertumoral Heterogeneity of 18F-FDG and 68Ga-PSMA Uptake in Prostate Cancer Pulmonary Metastases","volume":"44","author":"Perez","year":"2019","journal-title":"Clin. Nucl. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"24","DOI":"10.25259\/JCIS_52_2021","article-title":"Intracranial Metastasis from Prostate Cancer: Investigation, Incidence, and Imaging Findings in a Large Cohort of Australian Men","volume":"11","author":"McBean","year":"2021","journal-title":"J. Clin. Imaging Sci."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Dondi, F., Antonelli, A., Suardi, N., Guerini, A.E., Albano, D., Lucchini, S., Camoni, L., Treglia, G., and Bertagna, F. (2023). PET\/CT and Conventional Imaging for the Assessment of Neuroendocrine Prostate Cancer: A Systematic Review. Cancers, 15.","DOI":"10.3390\/cancers15174404"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1055\/s-0043-1768449","article-title":"Rare Isolated Cerebellar Metastases in Prostate Cancer: A Case Report with Review of Literature","volume":"22","author":"Ajit","year":"2023","journal-title":"World J. Nucl. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.1097\/RLU.0000000000002866","article-title":"68Ga-Prostate-Specific Membrane Antigen PET\/CT Findings in Extra-Axial Metastasis From Prostate Carcinoma","volume":"45","author":"Kulkarni","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/RLU.0000000000005050","article-title":"Cerebral and Muscular Metastases From Prostate Adenocarcinoma Initially Depicted by 177 Lu-PSMA SPECT\/CT","volume":"49","author":"Istatieh","year":"2024","journal-title":"Clin. Nucl. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/cup.12296","article-title":"Cutaneous Metastasis of Prostate Cancer: A Case Report and Review of the Literature with Bioinformatics Analysis of Multiple Healthcare Delivery Networks","volume":"41","author":"Brown","year":"2014","journal-title":"J. Cutan. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1111\/j.1600-0560.2007.00873.x","article-title":"Scrotal and Penile Papules and Plaques as the Initial Manifestation of a Cutaneous Metastasis of Adenocarcinoma of the Prostate: Case Report and Review of the Literature","volume":"35","author":"Wang","year":"2008","journal-title":"J. Cutan. Pathol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1097\/RLU.0000000000004817","article-title":"68Ga-PSMA PET\/CT Images of Multiple Cutaneous Metastases in a Patient With Prostate Carcinoma: Complete Response to 177Lu-PSMA-617 Treatment","volume":"48","author":"Sivrikoz","year":"2023","journal-title":"Clin. Nucl. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e443","DOI":"10.1097\/RLU.0000000000003225","article-title":"Inguinal Canal Deposit-An Uncommon Site of Metastases in Carcinoma Prostate Detected on 68Ga-Prostate-Specific Membrane Antigen PET\/CT","volume":"45","author":"Arora","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1007\/s00259-022-06089-w","article-title":"PSMA PET\/CT: Joint EANM Procedure Guideline\/SNMMI Procedure Standard for Prostate Cancer Imaging 2.0","volume":"50","author":"Fendler","year":"2023","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1148\/rg.2019180079","article-title":"Revisiting Prostate Cancer Recurrence with PSMA PET: Atlas of Typical and Atypical Patterns of Spread","volume":"39","author":"Barbosa","year":"2019","journal-title":"Radiographics"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2214\/AJR.21.26426","article-title":"Atypical Metastases in the Abdomen and Pelvis From Biochemically Recurrent Prostate Cancer: 11C-Choline PET\/CT with Multimodality Correlation","volume":"218","author":"Patra","year":"2022","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.eururo.2022.11.002","article-title":"Management of Patients with Advanced Prostate Cancer. Part I: Intermediate-\/High-Risk and Locally Advanced Disease, Biochemical Relapse, and Side Effects of Hormonal Treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022","volume":"83","author":"Gillessen","year":"2023","journal-title":"Eur. Urol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.juro.2018.05.164","article-title":"A Clinician\u2019s Guide to Next Generation Imaging in Patients With Advanced Prostate Cancer (RADAR III)","volume":"201","author":"Crawford","year":"2019","journal-title":"J. Urol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.euros.2024.06.006","article-title":"Survival Patterns Based on First-Site-Specific Visceral Metastatic Prostate Cancer: Are Outcomes of Visceral Metastases the Same?","volume":"66","author":"Ahmed","year":"2024","journal-title":"Eur. Urol. Open Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"904","DOI":"10.2967\/jnumed.119.231068","article-title":"Differential Expression of Glucose Transporters and Hexokinases in Prostate Cancer with a Neuroendocrine Gene Signature: A Mechanistic Perspective for 18F-FDG Imaging of PSMA-Suppressed Tumors","volume":"61","author":"Bakht","year":"2020","journal-title":"J. Nucl. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12967-022-03846-1","article-title":"Gene\u2019s Expression Underpinning the Divergent Predictive Value of [18F]F-Fluorodeoxyglucose and Prostate-Specific Membrane Antigen Positron Emission Tomography in Primary Prostate Cancer: A Bioinformatic and Experimental Study","volume":"21","author":"Bauckneht","year":"2023","journal-title":"J. Transl. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1080\/14737159.2023.2192351","article-title":"Radiomics and Theranostics with Molecular and Metabolic Probes in Prostate Cancer: Toward a Personalized Approach","volume":"23","author":"Filippi","year":"2023","journal-title":"Expert. Rev. Mol. Diagn."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e162907","DOI":"10.1172\/jci.insight.162907","article-title":"Reversible Epigenetic Alterations Mediate PSMA Expression Heterogeneity in Advanced Metastatic Prostate Cancer","volume":"8","author":"Sayar","year":"2023","journal-title":"JCI Insight"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/j.1440-1827.2008.02294.x","article-title":"Immunohistochemical Detection of Carcinoma in Radical Prostatectomy Specimens Following Hormone Therapy","volume":"58","author":"Kusumi","year":"2008","journal-title":"Pathol. Int."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Jiang, N., Zhu, S., Chen, J., Niu, Y., and Zhou, L. (2013). A-Methylacyl-CoA Racemase (AMACR) and Prostate-Cancer Risk: A Meta-Analysis of 4,385 Participants. PLoS ONE, 8.","DOI":"10.1371\/annotation\/677fdf34-651e-4dc8-a0be-d0d633237a85"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/pros.20277","article-title":"A Variant of the Alpha-Methyl-Acyl-CoA Racemase Gene Created by a Deletion in Exon 5 and Its Expression in Prostate Cancer","volume":"65","author":"Mubiru","year":"2005","journal-title":"Prostate"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1097\/00000478-200207000-00012","article-title":"Alpha-Methylacyl-CoA Racemase: A Novel Tumor Marker over-Expressed in Several Human Cancers and Their Precursor Lesions","volume":"26","author":"Zhou","year":"2002","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Ye, Z., Kou, Y., Shen, J., Dang, J., Tan, X., Jiang, X., Wang, X., Lu, H., Chen, S., and Cheng, Z. (2024). A Comparative Study of 18F-PSMA-1007 PET\/CT and Pelvic MRI in Newly Diagnosed Prostate Cancer. BMC Med. Imaging, 24.","DOI":"10.1186\/s12880-024-01376-4"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"10144","DOI":"10.1002\/chem.201003176","article-title":"New Molecular Markers for Prostate Tumor Imaging: A Study on 2-Methylene Substituted Fatty Acids as New AMACR Inhibitors","volume":"17","author":"Morgenroth","year":"2011","journal-title":"Chem. A Eur. J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e298","DOI":"10.1097\/RLU.0000000000005185","article-title":"Incidental Detection of Synchronous Benign Hepatic and Splenic Hemangiomas on 18 F-PSMA PET\/CT","volume":"49","author":"Alsaleh","year":"2024","journal-title":"Clin. Nucl. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1053\/j.semnuclmed.2023.11.001","article-title":"A Practical Guide to the Pearls and Pitfalls of PSMA PET Imaging","volume":"54","author":"Voter","year":"2024","journal-title":"Semin. Nucl. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"402","DOI":"10.4103\/ijnm.ijnm_65_23","article-title":"Cavernous Hepatic Hemangioma at 18F-Choline Positron Emission Tomography-Computed Tomography: Be Aware of the Pitfall","volume":"38","author":"Maffione","year":"2023","journal-title":"Indian. J. Nucl. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/s41391-022-00605-7","article-title":"Incidence and Survival of Castration-Resistant Prostate Cancer Patients with Visceral Metastases: Results from the Dutch CAPRI-Registry","volume":"26","author":"Kuppen","year":"2023","journal-title":"Prostate Cancer Prostatic Dis."}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/15\/1\/17\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:00:43Z","timestamp":1760115643000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/15\/1\/17"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":68,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["biom15010017"],"URL":"https:\/\/doi.org\/10.3390\/biom15010017","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,26]]}}}