PSMA PET/CT for prostate cancer diagnosis: current applications and future directions
Abstract Prostate cancer (PCa) requires improved diagnostic strategies beyond conventional imaging. This review aimed to evaluate the role of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in diagnosing advanced PCa. The review analyzed the diagnost...
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| Format: | Article |
| Language: | English |
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Springer
2025-05-01
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| Series: | Journal of Cancer Research and Clinical Oncology |
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| Online Access: | https://doi.org/10.1007/s00432-025-06184-z |
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| author | Zhengang Shen Zeng Li Yunlong Li Xiaodi Tang Jiayi Lu Li Chen Zhu Zhong Cheng Hong Liao Shukui Zhou |
| author_facet | Zhengang Shen Zeng Li Yunlong Li Xiaodi Tang Jiayi Lu Li Chen Zhu Zhong Cheng Hong Liao Shukui Zhou |
| author_sort | Zhengang Shen |
| collection | DOAJ |
| description | Abstract Prostate cancer (PCa) requires improved diagnostic strategies beyond conventional imaging. This review aimed to evaluate the role of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in diagnosing advanced PCa. The review analyzed the diagnostic performance of PSMA PET/CT in various clinical contexts, including locoregional staging, extracapsular extension (ECE), seminal vesicle invasion (SVI), pelvic lymph node metastases, distant metastases, and biochemical recurrence (BCR). Further, challenges such as PSMA-negative tumors, need for standardized protocols, and potential of emerging imaging targets (neurotensin receptor 1 and fibroblast activation proteins) were reviewed. The role of artificial intelligence (AI) and advancements in tracer development were explored. PSMA PET/CT demonstrated exceptional specificity for locoregional staging, ECE, and SVI while reducing unnecessary biopsies and optimizing biopsy strategies. The diagnostic accuracy for pelvic lymph node metastases was higher with PSMA PET/CT than with traditional methods, although sensitivity for micrometastasis detection remained challenging. For distant metastases, PSMA PET/CT outperformed bone scintigraphy (BS) and conventional imaging, particularly in identifying bone and atypical lesions. In BCR cases, PSMA PET/CT reliably detected recurrent lesions at low prostate-specific antigen levels, significantly influencing treatment strategies. The review findings indicate that PSMA PET/CT is a superior diagnostic tool for PCa due to its high specificity and accuracy. Despite limitations such as PSMA-negative tumors and sensitivity challenges, advancements in AI, novel imaging targets, and affordable tracer development hold promise for broader clinical adoption. This review underscores the transformative potential of PSMA PET/CT in PCa diagnosis and management, advocating for ongoing research and protocol standardization. |
| format | Article |
| id | doaj-art-129bd3f785e74e98b8a1b7c8281f02a4 |
| institution | DOAJ |
| issn | 1432-1335 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Cancer Research and Clinical Oncology |
| spelling | doaj-art-129bd3f785e74e98b8a1b7c8281f02a42025-08-20T02:39:23ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-05-01151511510.1007/s00432-025-06184-zPSMA PET/CT for prostate cancer diagnosis: current applications and future directionsZhengang Shen0Zeng Li1Yunlong Li2Xiaodi Tang3Jiayi Lu4Li Chen5Zhu Zhong Cheng6Hong Liao7Shukui Zhou8Department of Urology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Urology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Urology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaChengdu Medical CollegeHong Kong Baptist UniversityDepartment of Urology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Nuclear Medicine, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Urology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Urology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaAbstract Prostate cancer (PCa) requires improved diagnostic strategies beyond conventional imaging. This review aimed to evaluate the role of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in diagnosing advanced PCa. The review analyzed the diagnostic performance of PSMA PET/CT in various clinical contexts, including locoregional staging, extracapsular extension (ECE), seminal vesicle invasion (SVI), pelvic lymph node metastases, distant metastases, and biochemical recurrence (BCR). Further, challenges such as PSMA-negative tumors, need for standardized protocols, and potential of emerging imaging targets (neurotensin receptor 1 and fibroblast activation proteins) were reviewed. The role of artificial intelligence (AI) and advancements in tracer development were explored. PSMA PET/CT demonstrated exceptional specificity for locoregional staging, ECE, and SVI while reducing unnecessary biopsies and optimizing biopsy strategies. The diagnostic accuracy for pelvic lymph node metastases was higher with PSMA PET/CT than with traditional methods, although sensitivity for micrometastasis detection remained challenging. For distant metastases, PSMA PET/CT outperformed bone scintigraphy (BS) and conventional imaging, particularly in identifying bone and atypical lesions. In BCR cases, PSMA PET/CT reliably detected recurrent lesions at low prostate-specific antigen levels, significantly influencing treatment strategies. The review findings indicate that PSMA PET/CT is a superior diagnostic tool for PCa due to its high specificity and accuracy. Despite limitations such as PSMA-negative tumors and sensitivity challenges, advancements in AI, novel imaging targets, and affordable tracer development hold promise for broader clinical adoption. This review underscores the transformative potential of PSMA PET/CT in PCa diagnosis and management, advocating for ongoing research and protocol standardization.https://doi.org/10.1007/s00432-025-06184-zProstate cancer (PCa)PSMA PET/CT (Prostate-specific membrane antigen positron emission tomography/Computed tomography)Locoregional stagingPelvic lymph node metastasisMetastatic prostate cancerBiochemical recurrence |
| spellingShingle | Zhengang Shen Zeng Li Yunlong Li Xiaodi Tang Jiayi Lu Li Chen Zhu Zhong Cheng Hong Liao Shukui Zhou PSMA PET/CT for prostate cancer diagnosis: current applications and future directions Journal of Cancer Research and Clinical Oncology Prostate cancer (PCa) PSMA PET/CT (Prostate-specific membrane antigen positron emission tomography/Computed tomography) Locoregional staging Pelvic lymph node metastasis Metastatic prostate cancer Biochemical recurrence |
| title | PSMA PET/CT for prostate cancer diagnosis: current applications and future directions |
| title_full | PSMA PET/CT for prostate cancer diagnosis: current applications and future directions |
| title_fullStr | PSMA PET/CT for prostate cancer diagnosis: current applications and future directions |
| title_full_unstemmed | PSMA PET/CT for prostate cancer diagnosis: current applications and future directions |
| title_short | PSMA PET/CT for prostate cancer diagnosis: current applications and future directions |
| title_sort | psma pet ct for prostate cancer diagnosis current applications and future directions |
| topic | Prostate cancer (PCa) PSMA PET/CT (Prostate-specific membrane antigen positron emission tomography/Computed tomography) Locoregional staging Pelvic lymph node metastasis Metastatic prostate cancer Biochemical recurrence |
| url | https://doi.org/10.1007/s00432-025-06184-z |
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