Ga-68-PSMA and Ga-68-FAPI-04 PET/CT Findings With F-18-FDG PET/CT in a Patient With Recurrent Prostate Cancer

A 79-year-old man with prostate cancer was evaluated with Ga-68-prostate-specific membrane antigen (PSMA), Ga-68-FAPI-04, and F-18-FDG PET/CT scans since a rise in prostate-specific antigen was seen at last control while receiving chemotherapy. Abnormal FDG uptakes were observed in the tumoral areas of the left half of the prostate and walls of the bladder, although PSMA and FAPI activity were absent or lower in the relevant tumoral areas. Restaging Ga-68-PSMA and F-18-FDG PET/CT scans were obtained on the patient whose progression continued after transurethral tumor resection. Herein, we present a case proving intraindividual tumor heterogeneity in prostate cancer underwent PET/CT imaging with 3 different radiopharmaceuticals.