Tubarial salivary glands on PSMA ligands based PET imaging and post 177Lu PSMA therapy scan: reiterating its importance

Document Type : Case report

Authors

Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Abstract

68Ga-PSMA PET/CT has been routinely utilized in patients with intermediate to high-risk category prostate carcinoma for staging, biochemical recurrence and before planning the PSMA radioligand therapy (RLT). 177Lu-PSMA RLT has also been approved by FDA as a novel treatment modality in metastatic carcinoma prostate patients who have failed to other lines of treatment. The non-target organs like salivary and lacrimal glands have shown to have high physiological PSMA uptake on PSMA PET/CT. Recently, strong uptake of PSMA ligand has also been noted in the dorsal wall of the nasopharynx in the region of torus tubarius on PSMA PET/CT, which has led to the identification of new pair of salivary gland structures called “tubarial salivary glands”. The clinical significance of these distinct anatomical structures lies in the fact these structures might be involved in a variety of immune related, inflammatory disorders, malignancies and could be a probable organ at risk during radiotherapy in case of head and neck malignancies, causing adverse effects to the patient.

Keywords

Main Subjects

References

  1. Sartor O, de Bono J, Chi KN, Fizazi K, Herrmann K, Rahbar K, et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med. 2021; 385(12):1091-1103.
  2. Demirci E, Sahin OE, Ocak M, Akovali B, Nematyazar J, Kabasakal L. Normal distribution pattern and physiological variants of 68Ga-PSMA-11 PET/CT imaging. Nucl Med Commun. 2016; 37(11):1169-79.
  3. Nulent TJ, Valstar MH, de Keizer B, Willems SM, Smit LA, Al-Mamgani A, et al. Physiologic distribution of PSMA-ligand in salivary glands and seromucous glands of the head and neck on PET/CT. Oral surgery, oral medicine, oral pathology and oral radiology. 2018; 125(5):478-86.
  4. Valstar MH, de Bakker BS, Steenbakkers RJHM, de Jong KH, Smit LA, Klein Nulent TJW, et al. The tubarial salivary glands: A potential new organ at risk for radiotherapy. Radiother Oncol. 2021; 154: 292-98.
  5. Thakar A, Kumar R, Thankaraj AS, Rajeshwari M, Sakthivel P. Clinical implications of tubarial salivary glands. Radiotherapy and Oncology. 2021; 154: 319-20.
  6. Takano K, Kurose M, Kamekura R, Kanda M, Yamamoto M, Takahashi H. Tubarial gland involvement in IgG4-related diseases. Acta Otolaryngol. 2022; 142(7-8):616-619.
  7. Matsusaka Y, Yamane T, Fukushima K, Seto A, Matsunari I, Kuji I. Can the function of the tubarial glands be evaluated using [99mTc]pertechnetate SPECT/CT, [18F]FDG PET/CT, and [11C]methionine PET/CT? EJNMMI Res. 2021; 11(1): 34.
  8. Fendler WP, Eiber M, Beheshti M, Bomanji J, Ceci F, Cho S, Giesel F, et al. 68Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2017; 44(6): 1014-24.
  9. Sakthivel P, Thakar A, Arunraj ST, Prashanth A, Kumar R, Sharma SC, et al. Physiological PSMA uptake in the tubarial salivary glands and its implications in the PARIS protocol-A first study of its kind! Clin Nucl Med. 2021; 46(8): e398-e405.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 12, Issue 1
January 2024
Pages 43-45

Files

Share

How to cite

Statistics