Incidental [18F]PSMA-1007 Appendiceal Uptake Mimicking Nodal Disease

When interpreting an [18F]prostate specific membrane antigen (PSMA)-1007 PET/CT, it is important to understand the normal biodistribution of the tracer. A 73-year-old man with prostate cancer underwent [18F]PSMA-1007 PET/CT for biochemical recurrence. There was no abnormal uptake in the prostatectomy bed, but PSMA-avid pelvic nodal disease was found. Incidental intense focal uptake was also noted corresponding to the tip of the appendix, which was concluded to be physiological. This is an example of an uncommon site of physiological uptake of [18F]PSMA-1007 in the appendix.