False-Positive 18F-PSMA-1007 and True-Negative 18F-Fluorocholine PET/CT Splenic Hemangioma

Abstract A 62-year-old man with prostate cancer underwent both 18 F-PSMA-1007 and 18 F-fluorocholine PET/CT studies for biochemical recurrence. 18 F-PSMA-1007 PET/CT outperformed 18 F-fluorocholine PET/CT in detecting lymph node metastases in the pelvis and retroperitoneum, whereas the former showed a focus of increased uptake in the spleen not seen on 18 F-fluorocholine. The 18 F-PSMA-1007 –avid lesion corresponded to a splenic hemangioma, which was initially detected in an MRI scan 10 years ago, unchanged in size. This case shows different features of 18 F-PSMA-1007 and 18 F-fluorocholine uptake, in an incidentally detected splenic hemangioma, alerting PET/CT reports for possible pitfall.