0:00

So in this case we're going to be starting with the rotib

0:03

as always looking through for our physiological uptake

0:06

and focusing on the prostate.

0:07

And we can see underneath the bladder

0:09

that there is this area

0:10

of focal intense uptake in the region of the prostate.

0:14

So immediately we wanna calibrate that with our fused data.

0:18

So tumor nodes, metastases, we are gonna start

0:21

with the primary site, which is prostate

0:24

and there is some hydrogel in sit here

0:25

with some fiducial markers coming through.

0:28

And here we've got this intense focal uptake.

0:31

So I could put an SUV measurement on there.

0:33

I estimate it to be greater than 12.

0:35

So we put thinking about a primary score

0:37

if that's what we were doing.

0:38

Um, it's in the um, the central gland kind

0:41

of almost at the anterior fibromuscular stroma.

0:44

Um, and it's to the right of the midline.

0:46

So it is actually kind

0:47

of these midline lesions are really important

0:49

to think about their location

0:50

because if the ureter is there in the middle, um, it's it

0:54

consideration for our radiation oncology, um,

0:56

colleagues when they contour these for therapy,

0:58

I would probably describe this one

1:00

as focal intense uptake in the

1:04

prostate apex anteriorly to the right of the midline,

1:07

but crossing the midline to the left.

1:10

Um, and then I say there's my heterogeneous uptake elsewhere

1:12

or I might just not mention it at all.

1:14

And this kind of is this kind

1:16

of pattern up here at the base, you know,

1:17

it's benign symmetrical, it's sparing the peripheral gland.

1:20

I'm not too concerned about it.

1:22

So I'm happy that this is a primary tumor.

1:24

If I had an MR, I would be correlating with those results

1:27

and then I'd be looking through systematically

1:30

through the lymph nodes, through the external iliac

1:32

following those vessels up, really interrogating

1:34

those pelvic sidewalls.

1:35

And interestingly in this one, this is the ureter here.

1:38

I can see there's bright contrast in it.

1:39

There's some mild non-specific uptake there correlating

1:41

with this lymph node here.

1:43

And I would probably describe that in my report mildly avid.

1:46

Considered non-specific. I wouldn't say any uptake equals

1:49

and involve lymph node.

1:51

I think that would be over calling a lot of lymph nodes

1:53

because we do know that PSMA uptake can be seen in some

1:56

reactive pathology

1:58

and coming all the way up looking

2:00

through the retroperitoneum.

2:02

And then I'd be systematically looking

2:03

through then adjusting my liver

2:05

and looking through the skeleton for science

2:06

of metastatic disease, which were not present on this study.