The Role of 18F PSMA-1007 PET/CT in the Staging and Detection of Recurrence of Prostate Cancer, A Scoping Review

Prostate cancer is amongst one of the most diagnosed malignancies affecting adult men worldwide and exhibits broad clinical behavior. Early and accurate staging at initial diagnosis and for patients with biochemical recurrence is vital to guiding treatment decisions and improving oncological outcomes. This scoping review analyzes the current evidence landscape surrounding the role of 18F-PSMA-1007 PET/CT in the initial staging and detection of recurrent disease. This review highlights that 18F-PSMA-1007 PET/CT can upstage prostate cancer on initial staging and, when combined with multiparametric MRI, can downstage equivocal PIRADS 3 lesions. With regards to biochemical recurrence, 18F-PSMA-1007 PET/CT demonstrates a reasonable ability to detect recurrence at lower PSA levels compared to other commonly used radiotracers and can influence treatment decisions regarding salvage therapies. Notable limitations include poor specificity for bone lesions and inconsistent urinary excretion patterns. Further prospective multicenter trials are required to clearly delineate its role in Prostate cancer staging, however is likely useful as a second-line imaging modality in which locoregional recurrence is highly suspected with low PSA levels given its superior sensitivity performance.