E-PSMA: the EANM standardized reporting guidelines v1.0 for PSMA-PET

Abstract

Rationale The development of consensus guidelines for interpretation of Prostate-Specific Membrane Antigen (PSMA)-Positron Emission Tomography (PET) is needed to provide more consistent reports in clinical practice. The standardization of PSMA-PET interpretation may also contribute to increasing the data reproducibility within clinical trials. Finally, guidelines in PSMA-PET interpretation are needed to communicate the exact location of findings to referring physicians, to support clinician therapeutic management decisions. Methods A panel of worldwide experts in PSMA-PET was established. Panelists were selected based on their expertise and publication record in the diagnosis or treatment of PCa, in their involvement in clinical guidelines and according to their expertise in the clinical application of radiolabeled PSMA inhibitors. Panelists were actively involved in all stages of a modified, nonanonymous, Delphi consensus process. Results According to the findings obtained by modified Delphi consensus process, panelist recommendations were implemented in a structured report for PSMA-PET. Conclusions The E-PSMA standardized reporting guidelines, a document supported by the European Association of Nuclear Medicine (EANM), provide consensus statements among a panel of experts in PSMA-PET imaging, to develop a structured report for PSMA-PET in prostate cancer and to harmonize diagnostic interpretation criteria.

PSMA Expression Predicts Early Biochemical Response in Patients with Metastatic Castration-Resistant Prostate Cancer under 177Lu-PSMA-617 Radioligand Therapy

“…Besides the properties of the specific radiopharmaceutical, SUVs are also influenced by a variety of technical factors including image reconstruction and system resolution [36,37]. In addition, future studies may also test the predictive value of standardized reporting systems for outcome in the setting of mCRPC patients scheduled for RLT [38][39][40]. Furthermore, results of published and ongoing prospective trials using PSMA-directed treatment in end-stage disease may set the scene for a more widespread adoption of this promising treatment earlier in the therapeutic algorithm of PC patients [37].…”

PSMA-PET/CT in Patients with Recurrent Clear Cell Renal Cell Carcinoma: Histopathological Correlations of Imaging Findings

“…In order to standardize the interpretation of PSMA-PET/CT examinations and to increase comparability and reproducibility in clinical trial, consensus interpretation guidelines were developed by an international panel [ 8 ]. The mediastinal blood pool activity as well as parotideal and liver tracer uptakes have been proposed as references, leading to a qualitative score to describe the degree of PSMA avidity of a lesion.…”

“…The lesion-to-muscle ratio of SUVmax was calculated. A PSMA expression visual score was used to qualitatively assess tracer uptake in relation to reference tissues: Score 0, below blood pool; 1, equal to or above blood pool and lower than liver; 2, equal to or above liver and lower than parotid gland; 3, equal to or above parotid gland [ 8 ]. Maximum lesion diameter and lesion volume were determined on morphologic imaging.…”

Theranostics in Oncology—Thriving, Now More than Ever

“…As with any imaging modality, indeterminate findings may occur, which should not provide misleading information to the referring urologists [ 20 ]. Therefore, standardized frameworks for PSMA scan interpretation have been introduced, including PROMISE, E-PSMA or the PSMA-Reporting and Data System (PSMA-RADS) [ 21 , 22 , 23 ]. The latter framework includes PSMA-RADS-3A lesions, which describes findings that have equivocal uptake in a soft tissue site that would be typical for metastatic PC, such as pelvic or retroperitoneal lymph nodes.…”