PSMA PET/CT Reporting: Real-Life Inconsistencies, Heterogeneity, and Underutilization of Scoring Systems and Interpretation Frameworks

Prostate-specific membrane antigen (PSMA) PET/CT has revolutionized prostate cancer management. Its clinical utility has been demonstrated in multiple prospective clini cal trials leading to regulatory approval by the U.S. Food and Drug Administration in 2020 (1–3). PSMA PET/CT has been widely adopted clinically (4) and is part of guideline- recommended diagnostic assessment (5). Recognizing that standardizing interpretation is integral to the long-term suc cess of this technique, expert groups across the world have developed various scoring systems and interpretation frame works (eg, PRIMARY, miTNM/PROMISE [Prostate Cancer Molecular Imaging Standardized Evaluation], PSMA Report ing and Data System [PSMA-RADS], PSMA PET Proges sion [PPP] Criteria, RECIP [Response Evaluation Criteria in PSMA PET/CT], E-PSMA). However, the extent to which they are in use or whether efforts to achieve reporting stan dardization have been successful is unknown. The purpose of this study was to evaluate PSMA PET/CT reports from vari ous institutions in terms of length, content, structure, read ability, and utilization of standardized scoring systems and interpretation frameworks.