PSMA PET/CT report

A report skeleton that follows the EANM/SNMMI PSMA PET guideline 2.0 (2023) and the PROMISE v2 molecular-imaging TNM (miTNM) framework. Copy it into your reporting system and fill the brackets.

PSMA PET/CT

CLINICAL INDICATION:
  [Primary staging / biochemical recurrence / pre-radioligand therapy]
  PSA [ ] ng/mL on [date]; PSA doubling time [ ]; Gleason / ISUP grade [ ]
  Prior treatment: [prostatectomy / radiotherapy / ADT / ARPI / chemotherapy]

TECHNIQUE:
  Radiopharmaceutical: [68Ga-PSMA-11 / 18F-DCFPyL / 18F-PSMA-1007 / other]
  Administered activity: [ ] MBq at [time]; uptake time [ ] min
  Coverage: [skull base / vertex] to [mid-thigh]; CT: [low-dose / diagnostic contrast-enhanced]
  Furosemide: [yes, dose / no]

COMPARISON:
  [Prior PSMA PET, CT, MRI, bone scan / none]

FINDINGS:
  Prostate / prostate bed (miT): [ ]
  Pelvic lymph nodes (miN): [site, short-axis size, SUVmax]
  Extrapelvic lymph nodes (miM1a): [ ]
  Bone (miM1b): [unifocal / oligometastatic (≤3) / disseminated / diffuse marrow]
  Other organs (miM1c): [ ]
  PSMA expression of the most intense lesion (PROMISE v2): [0 / 1 / 2 / 3]
  Incidental findings: [ ]
  Physiological uptake and known pitfalls (ganglia, fractures, Paget disease, other tumours) considered.

IMPRESSION:
  1. miTNM (PROMISE v2): miT[ ] miN[ ] miM[ ]
  2. [Summary of disease burden and change from prior imaging]
  3. [Recommendation, e.g. correlation or biopsy of an equivocal lesion]

PSMA expression score (PROMISE v2)

Before you sign

• State the tracer — uptake time and urinary excretion differ (¹⁸F-PSMA-1007 has little urinary activity but more benign bone uptake).
• Coeliac, stellate and sacral ganglia and healing fractures are common false positives.
• About 5–10% of prostate cancers are PSMA-negative; a negative scan at very low PSA does not exclude recurrence.
• Before ¹⁷⁷Lu-PSMA therapy, report whether any lesion meets size criteria but lacks PSMA uptake (VISION exclusion).

Sources: Fendler WP et al., Eur J Nucl Med Mol Imaging 2023; Seifert R et al., Eur Urol 2023 (PROMISE v2).