ArticleEuropean journal of nuclear medicine and molecular imaging2026
Diagnostic impact of interpretation criteria for [
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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1 citing paper in PubMed.
- Diagnostic accuracy ofJapanese journal of radiology · 2026Article
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19 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe PSMA Reporting and Data System (PSMA-RADS) has been proposed to standardize the interpretation of PSMA-PET. However, its diagnostic performance has not been fully validated. This study aimed to determine the optimal interpretation criteria for PSMA-PET and to compare its diagnostic performance with conventional imaging.
methodsThis prospective study enrolled 284 patients across various disease stages who underwent [¹⁸F]PSMA-1007 PET/CT. Diagnostic performance was evaluated using different positivity thresholds based on PSMA-RADS categories, PSMA-expression scores, and SUVmax, and was compared with that of CT and bone scan (BS). True-positive rates were summarized across PSMA-RADS categories.
resultsA total of 771 lesions were analyzed. PSMA-RADS demonstrated superior diagnostic performance compared with other interpretation criteria. Using PSMA-RADS-4 as the positivity threshold, [¹⁸F]PSMA-1007 PET/CT achieved a sensitivity of 78.5% and a specificity of 95.3%. PSMA-RADS-3 increased sensitivity to 98.4% but reduced specificity to 58.8%. PSMA-expression score 2 yielded a sensitivity of 52.2% and a specificity of 99.3%, whereas SUVmax cutoff of 5.7 yielded a sensitivity of 72.6% and a specificity of 85.8%. When PSMA-RADS-4 was used as the positivity threshold, PET/CT showed higher sensitivity than CT (81.3% vs. 48.6%) and BS (84.5% vs. 65.7%), as well as higher accuracy (83.2% vs. 56.2% and 87.6% vs. 74.5%, respectively). The true-positive rate of PSMA-RADS-3 lesions was 69.7%, which was substantially lower than that of PSMA-RADS-4 lesions (96.7%).
conclusionPSMA-RADS-4 represents an optimal positivity threshold for [¹⁸F]PSMA-1007 PET/CT, providing superior diagnostic performance compared with CT and BS and supporting its clinical utility for standardized image interpretation.
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