Proposed Criteria Positions PSMA PET for the Future

Prostate cancer is an oncologic disease that has been deprived of the benefits of molecular imaging in this era of oncologic 18F-FDG PET/CT compared with other tumor types due to its inherent biologic predilection for fatty acid rather than glucose metabolism. Because of this unmet clinical need, there has been an increased interest and development of emerging non-18F-FDG PET radiotracers for prostate cancer including choline (11C-choline, 18F-fluorocholine, 18F-fluoromethylcholine), acetate (11C-acetate, 18F-fluoroacetate), and amino acid-based (18F-fluciclovine) agents. However, these new PSMA PET radiotracers will need to deliver on this initial promise in the next phase of their development for it to become a valuable tool for patient management and drug development for prostate cancer in forthcoming systematic multicenter clinical trials. A standardized reporting system for incorporation of PSMA PET imaging to meet upcoming clinical diagnostic and clinical research needs requires an efficient but accurate method to meet the needs for the imager, referring treating clinicians, and multicenter clinical trials.