PSMA PET/CT in contemporary prostate cancer management: From initial staging to biochemical recurrence.
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OBJECTIVE: Prostate-Specific Membrane Antigen (PSMA) PET/CT has rapidly become the preferred first-line imaging modality for primary staging of unfavourable intermediate-risk, high-risk, and very high-risk prostate cancer, and for restaging at biochemical recurrence. The objective of this review is to provide nuclear medicine physicians with a comprehensive and practical framework for PSMA PET/CT interpretation, structured reporting, and clinical decision integration, with emphasis on primary staging evidence, biochemical recurrence (BCR) detection rates, imaging pitfalls, and the PSMA-RADS reporting system. METHODS: A narrative review of published evidence was performed, encompassing landmark randomised controlled trials and guideline documents from the EAU, EANM, and NCCN. Key trials reviewed included proPSMA, OSPREY, PRIMARY, CONDOR, and VISION. RESULTS: F-Choline (84% vs 69%, OR 2.53, p<0.001). CONCLUSION: F-PSMA-1007 - are core professional competencies of the nuclear medicine physician.
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