Increased Petrous Bone Uptake on 18F-PSMA-1007 PET/CT Due to Otospongiosis

We report the case of a 74-year-old man who had undergone radical prostatectomy for prostatic cancer 6 months earlier. Elevated prostate-specific antigen during follow-up prompted F-18-prostate-specific membrane antigen (PSMA) ligand PET/CT (F-18-PSMA-1007 PET/CT) to search for new manifestations of prostate cancer, revealing an increased focal uptake (SUVmax, 5.9) in the left cochlear/pericochlear temporal bone and equivocal PSMA-RADS-3a external iliac nodes. Comparison with cone-beam CT and MRI showed that the focal temporal bone uptake corresponded to the typical morphological features of active otospongiosis (otosclerosis) in the context of a previously known long-standing otospongiosis.

Automated summary

We present a case of a 74-year-old man who had previously undergone radical prostatectomy for prostatic cancer. Follow-up imaging detected elevated prostate-specific antigen, prompting the use of F-18-prostate-specific membrane antigen (PSMA) ligand PET/CT scan. The scan revealed increased focal uptake in the temporal bone and equivocal external iliac nodes, which were subsequently confirmed to be related to otospongiosis.