Prostate-specific Membrane Antigen Reporting and Data System Version 2.0

Rudolf A Werner; Philipp E Hartrampf; Wolfgang P Fendler; Sebastian E Serfling; Thorsten Derlin; Takahiro Higuchi; Kenneth J Pienta; Andrei Gafita; Thomas A Hope; Martin G Pomper; Matthias Eiber; Michael A Gorin; Steven P Rowe

doi:10.1016/j.eururo.2023.06.008

Prostate-specific Membrane Antigen Reporting and Data System Version 2.0

Eur Urol. 2023 Nov;84(5):491-502. doi: 10.1016/j.eururo.2023.06.008. Epub 2023 Jul 4.

Authors

Affiliations

¹ Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany; The Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
³ Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
⁴ Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
⁵ Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany; Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
⁶ The Brady Urological Institute Johns Hopkins School of Medicine, Baltimore, MD, USA.
⁷ The Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁸ Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
⁹ The Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Brady Urological Institute Johns Hopkins School of Medicine, Baltimore, MD, USA.
¹⁰ Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
¹¹ Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹² The Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Brady Urological Institute Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address: srowe8@jhmi.edu.

PMID: 37414701
DOI: 10.1016/j.eururo.2023.06.008

Abstract

Prostate-specific Membrane Antigen Reporting and Data System (PSMA-RADS) was introduced for standardized reporting, and PSMA-RADS version 1.0 allows classification of lesions based on their likelihood of representing a site of prostate cancer on PSMA-targeted positron emission tomography (PET). In recent years, this system has extensively been investigated. Increasing evidence has accumulated that the different categories reflect their actual meanings, such as true positivity in PSMA-RADS 4 and 5 lesions. Interobserver agreement studies demonstrated high concordance among a broad spectrum of ⁶⁸Ga- or ¹⁸F-labeled, PSMA-directed radiotracers, even for less experienced readers. Moreover, this system has also been applied to challenging clinical scenarios and to assist in clinical decision-making, for example, to avoid overtreatment in oligometastatic disease. Nonetheless, with an increasing use of PSMA-RADS 1.0, this framework has shown not only benefits, but also limitations, for example, for follow-up assessment of locally treated lesions. Thus, we aimed to update the PSMA-RADS framework to include a refined set of categories in order to optimize lesion-level characterization and best assist in clinical decision-making (PSMA-RADS version 2.0).

Keywords: Prostate carcinoma; Prostate-specific membrane antigen; Reporting and data system; Structured reporting.

Abstract

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