[Indications for performing PSMA-PET-CT as part of prostate cancer diagnostics].

Abstract

Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) is increasingly being applied in the diagnostic landscape of prostate cancer. This study aims to elucidate and assess both established and emerging indications for PSMA-PET/CT imaging. Current evidence on PSMA-PET/CT is summarised, with relevant guideline recommendations and enhanced by recent study findings. PSMA-PET/CT demonstrates superiority over conventional imaging techniques and can be applied either complementarily or substitutively across all stages of prostate cancer based on clinical indications. It offers advantages in terms of reduced time and radiation exposure. PSMA-PET/CT use enables a more accurate assessment of disease status and facilitates optimised treatment planning. Applications span from initial cancer suspicion through diagnosis, staging, and therapeutic planning in cases of biochemical recurrence and metastatic prostate cancer. However, evidence for the prognostic value of PSMA-PET/CT-guided therapy decisions is currently limited. PSMA-PET/CT provides substantial diagnostic and therapeutic benefits for nearly all subgroups of prostate cancer patients. Its use supports the evaluation of possible intensification or de-escalation strategies, thereby enabling personalised treatment planning.