Evidence map›Paper›PMID 41364231›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2026

PSMA PET/CT for the detection of prostate cancer biochemical recurrence after primary radiation therapy: is it time to review the Phoenix criteria?

Laura Evangelista, Carlo Vallone, Priscilla Guglielmo, Sara Damiani, Jelena Jandric, Andrea Brignoli, Manuela Marenco, Francesco Martino, Luciana Di Cristina, Ciro Franzese and 1 more

Abstract readMulticenter Study
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In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Laura EvangelistaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Carlo ValloneDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Priscilla GuglielmoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. priscilla.guglielmo@yahoo.it.ORCID 0000-0001-9150-4367
Sara DamianiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Jelena JandricNuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Andrea BrignoliDepartment of Radiotherapy, Humanitas Gavazzeni, Bergamo, Italy.
Manuela MarencoNuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Francesco MartinoDepartment of Radiotherapy, Humanitas Gavazzeni, Bergamo, Italy.
Luciana Di CristinaRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Ciro FranzeseDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Rosario MazzolaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBiochemical recurrence (BCR) in prostate cancer (PCa) after definitive radiotherapy (RT) is defined by a PSA rise ≥ 2.0 ng/mL (Phoenix criteria, Pc). In clinical settings, PSMA PET/CT has demonstrated the ability to identify recurrent disease in case of PSA values remain below this threshold. This retrospective, multicentre study evaluated PSMA PET/CT in patients with rising PSA below the Phoenix-threshold. MATERIALS AND

methodsWe retrospectively analysed PCa patients who underwent PSMA PET/CT for rising PSA below Pc in the period 2020-2023. Patients with prior recurrence treatments were excluded. PSMA PET/CT findings were classified by prostate cancer molecular imaging standardized evaluation (PROMISE) score and stratified by D'Amico risk. Treatment decisions were extracted from clinical records. A non‑parametric statistical analysis was employed (MedCalc® software).

resultsSixty patients were included (median age 79 years, IQR: 75-82). Median PSA value was 1.25 ng/ml (range 0.12-5.02), and median PSA doubling time was 11.8 months (range 0-87.9). The overall PSMA PET/CT detection rate was 71.7% (n = 43/60). Of those with positive scans, 81% (n = 35/43) were oligo‑metastatic and 19% (n = 8/43) were multi‑metastatic. According to the PROMISE score, 10 (23%) patients had only local recurrence, 10 (23%) only pelvic lymph node disease, 10 (23%) only distant metastases, 13 (31%) had local and distant disease (both lymph nodes and bone metastases). By D'Amico risk classification, 83.9% (30/35) of unfavourable intermediate/high‑risk patients had a positive PET, compared with 52.0% (13/25) of low/favourable intermediate‑risk patients (chi squared, p < 0.05). Follow‑up data were available for 54 patients (90%). In 92.6% (n = 50/54), PET findings guided therapy choice: 97% (n = 38/39) of PET‑positive patients received additional treatment (hormonal therapy, RT, or chemotherapy), whereas 80% (n = 12/15) of PET‑negative patients were managed with watchful waiting (chi-square, p < 0.001).

conclusionsPSMA PET/CT detects PCa recurrence in about 72% of patients with PSA rises below Phoenix-threshold. By identifying disease at an earlier stage, many patients may become eligible for salvage or metastasis-directed therapies.

Indexed as

Glutamate Carboxypeptidase IINeoplasm Recurrence, LocalPositron Emission Tomography Computed TomographyProstatic NeoplasmsAgedAged, 80 and overAntigens, SurfaceHumansMaleProstate-Specific AntigenRecurrenceRetrospective StudiesAntigens, SurfaceFOLH1 protein, humanGlutamate Carboxypeptidase IIProstate-Specific AntigenBiochemical recurrencePhoenix criteriaProstate cancerPSMA PETRadiation treatment

Identifiers

PMID41364231

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