⁶⁸Ga-PSMA-11 PET Identified Tumor Recurrence in Prostatectomy Bed with Rising PSA of 0.9 ng/mL but Negative on MRI and ¹⁸F-Fluciclovine PET Scan

A 63-year-old man with prostate cancer was treated with prostatectomy who had postoperative PSA of 0.6 ng/mL. A pelvic MRI, whole body bone scan, CT chest and abdomen exams did not show any residual or metastatic prostate disease. His PSA increased to 0.9 ng/mL in two months. A fluciclovine PET did not show any tracer avid metastatic or recurrent disease. A 0.7 cm non-fluciclovine-avid nodule at the left prostatectomy bed was considered benign. A 68Ga-PSMA-11 PET one month later showed avid radiotracer uptake within this nodule. The patient received androgen deprivation treatment after PSMA PET/CT and responded well.