Urinary Reflux Mimicking Seminal Vesicle Invasion on 99m Tc-HYNIC-PSMA SPECT/CT : Clarification by Concurrent Bone Scintigraphy.

Rabani, Faeze; Saber Tanha, Amin; Taheri, Fatemeh; Afshari, Nima; Askari, Emran · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 67-year-old man with lower urinary tract symptoms underwent transurethral resection of the prostate (TURP), revealing prostatic adenocarcinoma. Staging with 99m Tc-HYNIC-PSMA SPECT/CT demonstrated focal uptake at the prostate mid-to-base and left seminal vesicle, initially suggesting miT3b disease. However, a subsequent bone scan revealed an identical uptake pattern inferior to the bladder, confirming a urinary artifact rather than true PSMA-avid tumor involvement. This case underscores a recognized pitfall of PSMA imaging following TURP and highlights the value of correlative imaging in preventing false-positive interpretation and ensuring accurate staging.

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