Performance of 68Ga-PSMA PET/CT for Prostate Cancer Management at Initial Staging and Time of Biochemical Recurrence

Purpose of the Review Recently introduced Gallium-68 labeled PSMA-ligands such as HBED-CC (Ga-68-PSMA) have shown promise for unmet diagnostic needs in prostate cancer. Recent Findings Ga-68-PSMA has demonstrated improved detection rates and specificity for prostate cancer compared to standard imaging approaches. In the setting of primary disease, Ga-68-PSMA appears to preferentially identify treatment-relevant intermediate and high-risk prostate cancer. There is also a growing evidence that Ga-68-PSMA positron emission tomography (PET) outperforms alternative conventional imaging methods including choline-based radiotracers for the localization of disease sites at biochemical recurrence, particularly at lower prostate-specific antigen (PSA) levels (< 1 ng/mL). However, the majority of published work lacks rigorous verification of imaging results. Summary Ga-68-PSMA offers significant promise for both, primary disease and biochemically recurrent prostate cancer. The evidence base to support Ga-68-PSMA is however still underdeveloped, and more rigorous studies substantiating efficacy are needed.