Can Ga-68 PSMA PET/CT replace conventional imaging modalities for primary lymph node and bone staging of prostate cancer?

Imaging is critical for primary staging of prostate cancer. Traditional imaging modalities (computerized tomography scan and nuclear medicine bone scans) are limited by their suboptimal diagnostic performance. Recent meta-analyses have demonstrated that nuclear imaging with 68Ga-labeled prostate-specific membrane antigen ligand (68Ga-PSMA) using positron emission tomography/computed tomography (PET/CT) has higher sensitivity and specificity in this setting compared to conventional imaging techniques. 68Ga-PSMA PET/CT for whole-body assessment can be used as the sole imaging modality for primary lymph node and bone staging of prostate cancer. Patient summary There is a rapidly growing body of evidence that nuclear imaging with 68Ga-labeled prostate-specific membrane antigen ligand using positron emission tomography/computed tomography has a higher detection rate for lymph node and bone metastases in prostate cancer patients. This approach has strong potential to replace conventional techniques in the primary setting in the near future.