Novel 64 Cu-labeled Trimeric PSMA Ligand Unequivocally Identifies Local Recurrence of Prostate Cancer Ambiguously Imaged by 18 F-DCFPyL PSMA PET/CT.

A 72-year-old man underwent 18 F-DCFPyL PSMA PET/CT imaging for the localization of biochemical recurrence (BCR) of prostate cancer. The scan revealed no definite findings, with only a vague uptake of uncertain significance in the bladder neck region. An additional PET/CT scan using a 64 Cu-labeled trimeric PSMA ligand demonstrated astonishing distinct uptake in the former prostate bed, unequivocally confirming the presence of a small local recurrence and allowing for targeted local therapy. This intriguing case highlights the potential of PET/CT using 64 Cu-labeled trimeric PSMA ligands, especially when conventional PSMA PET/CT scans yield ambiguous results.