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.
基金:
China Health Commission of Sichuan Province Medical Science and Technology Program [23LCYJ004]; Health Commission of Sichuan Province Medical Science and Technology Program; Precision Evaluation Using 18F-PSMA-1007 PET/CT
第一作者机构:[1]Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Clin Res Ctr Canc,Dept Urol, Sichuan Canc Ctr,Affiliated Canc Hosp, Chengdu, Peoples R China[2]Chengdu Med Coll, Chengdu, Peoples R China
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推荐引用方式(GB/T 7714):
Shen Zhengang,Li Zeng,Li Yunlong,et al.PSMA PET/CT for prostate cancer diagnosis: current applications and future directions[J].JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY.2025,151(5):doi:10.1007/s00432-025-06184-z.
APA:
Shen, Zhengang,Li, Zeng,Li, Yunlong,Tang, Xiaodi,Lu, Jiayi...&Zhou, Shukui.(2025).PSMA PET/CT for prostate cancer diagnosis: current applications and future directions.JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY,151,(5)
MLA:
Shen, Zhengang,et al."PSMA PET/CT for prostate cancer diagnosis: current applications and future directions".JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 151..5(2025)