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Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) of prostate cancer: current and emerging applications

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Abstract

Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) is transforming the management of patients with prostate cancer. In appropriately selected patients, PSMA-PET offers superior sensitivity and specificity compared to conventional imaging (e.g., computed tomography and bone scintigraphy) as well as choline and fluciclovine PET, with the added benefit of consolidating bone and soft tissue evaluation into a single study. Despite being a newly available imaging tool, PSMA-PET has established indications, interpretation guidelines, and reporting criteria, which will be reviewed. The prostate cancer care team, from imaging specialists to those delivering treatment, should have knowledge of physiologic PSMA radiotracer uptake, patterns of disease spread, and the strengths and limitations of PSMA-PET. In this review, current and emerging applications of PSMA-PET, including appropriateness use criteria as well as image interpretation and pitfalls, will be provided with an emphasis on clinical implications.

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Funding

H.C. receives research funds from Clovis Oncology, Color Genomics, Janssen, Medivation, Promontory Pharmaceutics, and Sanofi. H.C. was a consultant for AstraZeneca and receives royalties from UpToDate. A.I. has performed prior consulting for Curium. D.C. has received in-kind support from Telix for a clinical trial and is on the speaker's bureau for Lantheus Medical.

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Authors and Affiliations

  1. Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA

    Shamus Moran

  2. Division of Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA

    Heather H. Cheng

  3. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Heather H. Cheng

  4. Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA

    Emily Weg

  5. Division of Urologic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

    Eric H. Kim

  6. Division of Nuclear Medicine, Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA

    Delphine L. Chen & Amir Iravani

  7. Fred Hutchinson Cancer Center, Seattle, WA, USA

    Delphine L. Chen & Amir Iravani

  8. Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, 4559 Scott Ave., Mail Stop Code: 8131, St. Louis, MO, 63110, USA

    Joseph E. Ippolito

  9. Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

    Joseph E. Ippolito

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Moran, S., Cheng, H.H., Weg, E. et al. Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) of prostate cancer: current and emerging applications. Abdom Radiol 49, 1288–1305 (2024). https://doi.org/10.1007/s00261-024-04188-w

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