18F-FDG PET/CT Versus68Ga-PSMA-11 PET/CT in Evaluation of Distant Metastatic Disease in Recurrent Renal Cell Carcinoma

Prostate-specific membrane antigen (PSMA) expression has been observed in the neovasculature of various malignancies. We present a case of metastatic renal cell carcinoma (RCC) with comparative 18F-FDG PET/CT and 68Ga-PSMA-11 imaging in which FDG PET/CT failed to detect metastatic thyroid disease and showed less 18F-FDG-concentrating lesions at other sites, whereas 68Ga-PSMA-11 PET/CT identified metastatic thyroid disease and demonstrated intensely 68Ga-PSMA-11-expressing distant metastatic lesions. 68Ga-PSMA-11 PET/CT may be considered a potentially useful imaging technique in RCC to detect metastasis and to guide the choice of specific treatments, such as PSMA-based radionuclide therapy in patients with recurrent metastatic RCC.