Top Line: Who wouldn’t love standardized PSMA-PET reads to ease clinically applicability?
The Study: PSMA-PET imaging is an amazing tool offering unprecedented information about a patient’s disease status, but its potential remains widely untapped without in-depth reads. The Standardised PSMA PET/CT Analysis and Reporting Consensus (SPARC) project convened 30 international experts across urology, oncology, and nuclear medicine to harmonize PSMA-PET reporting. Consensus was clear that PSMA-PET is best for staging high-risk disease and biochemical recurrence. Endorsed frameworks for reporting include the PRIMARY score for intraprostatic lesions, which mirrors MRI-based PI-RADS scoring to describe clinically-significant disease by specifying site, pattern, and intensity of uptake on a 5-point scale. A similar 5-point Likert scale is recommended for reporting diagnostic certainty of distant sites ranging from 1 (benign) to 5 (definitely prostate cancer). It also recommends synthesizing the above into molecular imaging (mi)TNM staging, which mirrors AJCC staging but uses PSMA-PET findings rather than conventional CT/MRI/bone scans to provide structured and reproducible reporting across institutions. Finally, it recommends mandatory reporting of PSMA volume (PSMA-VOL), SUVmax, and lesion counts in advanced settings which may play a future role in treatment stratification based on disease burden as well as treatment response assessments.
TBL: SPARC delivers incredibly useful consensus standardization of PSMA-PET reporting, laying the groundwork for cleaner communication and trial-ready imaging endpoints. | Herrmann, Eur Urol 2025
The Study: PSMA-PET imaging is an amazing tool offering unprecedented information about a patient’s disease status, but its potential remains widely untapped without in-depth reads. The Standardised PSMA PET/CT Analysis and Reporting Consensus (SPARC) project convened 30 international experts across urology, oncology, and nuclear medicine to harmonize PSMA-PET reporting. Consensus was clear that PSMA-PET is best for staging high-risk disease and biochemical recurrence. Endorsed frameworks for reporting include the PRIMARY score for intraprostatic lesions, which mirrors MRI-based PI-RADS scoring to describe clinically-significant disease by specifying site, pattern, and intensity of uptake on a 5-point scale. A similar 5-point Likert scale is recommended for reporting diagnostic certainty of distant sites ranging from 1 (benign) to 5 (definitely prostate cancer). It also recommends synthesizing the above into molecular imaging (mi)TNM staging, which mirrors AJCC staging but uses PSMA-PET findings rather than conventional CT/MRI/bone scans to provide structured and reproducible reporting across institutions. Finally, it recommends mandatory reporting of PSMA volume (PSMA-VOL), SUVmax, and lesion counts in advanced settings which may play a future role in treatment stratification based on disease burden as well as treatment response assessments.
TBL: SPARC delivers incredibly useful consensus standardization of PSMA-PET reporting, laying the groundwork for cleaner communication and trial-ready imaging endpoints. | Herrmann, Eur Urol 2025