Complimentary Pattern of Uptake in 18F-FDG PET/CT and 68Ga-Prostate-Specific Membrane Antigen PET/CT in a Case of Metastatic Clear Cell Renal Carcinoma

We describe a case of metastatic clear cell renal cell carcinoma with intensely tracer concentrating lesions in left suprarenal region, mediastinal lymph nodes, lytic bone lesions, thyroid nodules, and mild abnormal tracer-avid lung nodules in Ga-68-prostate-specific membrane antigen (PSMA) PET/CT. On the other hand F-18-FDG PET/CT showed mild to no significant abnormal uptake in these lesions. Complimentary uptake pattern was observed in Ga-68-PSMA and F-18-FDG PET images in thyroid lesions and D5 vertebral lesion. This case highlights the possibilities of imaging clear cell renal cell carcinoma with Ga-68-PSMA and opens the possibility of treatment with Lu-177-PSMA.