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We have reported here the case of a 69-year-old man who presented with spinal cord compression due to bone metastases as the first manifestation of hepatocellular carcinoma (HCC). For the initial staging, the patient underwent 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) imaging, which demonstrated mild 18 F-FDG uptake in the multiple expansile osteolytic bone lesions, but no remarkable atypical 18 F-FDG uptake in the liver lesion on low-doses CT. An additional PET/CT scan was performed to evaluate the prostate-specific membrane antigen (PSMA) expression, which has recently been reported to be a potential biological marker in a variety of tumors including HCC. High PSMA uptake was recorded in both the metastatic bone lesions and the primary liver lesion/tumor by the 68 Ga-PSMA PET/CT.

Comparative Findings Between <sup>68</sup>Ga-PSMA and <sup>18</sup>F-FDG PET/CT for Hepatocellular Carcinoma