Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is an evolving diagnostic tool for prostate cancer. There is a need to harmonise existing guidelines and reporting recommendations for PSMA PET/CT. The Standardised PSMA PET/CT Analysis and Reporting Consensus (SPARC) project aims to consolidate classifications and recommendations by a multidisciplinary and international group of experts under one cohesive framework, establishing a dynamic and evolving structure for PSMA PET/CT reporting.
We employed a cross-sectional iterative process to define opinions and evaluate consensus. Thirty expert panel members, representing diverse specialities and geographic areas, were selected. A methods expert led the design, data collection, and analysis. Five groups of international multidisciplinary prostate cancer experts convened for literature review and formulation of statements on standardised reporting, detection, primary staging, biochemical recurrence, and treatment response. The groups compiled 91 statements for a two-round modified Delphi survey. The "RAND appropriateness method" was used for the analysis.
Consensus increased to 93% between two rounds. The panel endorsed and adopted the following frameworks for reporting of PSMA PET/CT: molecular imaging PSMA for expression level and certainty, miTNM by PROMISE for reporting of PSMA PET/CT, the PRIMARY score for intraprostatic staging, PSMA volume, mean standardised uptake value, and maximum standardised uptake value (SUVmax). There were uncertainty about correlating PSMA PET/CT with conventional imaging risk groups in newly diagnosed metastatic prostate cancer and a lack of agreement that clinical management plans based upon PSMA PET/CT improved outcomes. There was consensus that SUVmax should be reported regionally, rather than reporting a single site. There were insufficient data to standardise a definition of response or progression by PSMA PET/CT.
SPARC provides a standardised PSMA PET/CT analysis and reporting consensus to serve as a future reference for PSMA PET/CT reporting. Integration of common PSMA PET reporting criteria under one umbrella improves the explanation of imaging findings between imaging experts and treating clinicians for clinical implementation.
European urology. 2025 Sep 12 [Epub ahead of print]
Ken Herrmann, Jochen Walz, Steven MacLennan, Alberto Briganti, Philip Cornford, Johannes Czernin, Matthias Eiber, Stefano Fanti, Wolfgang P Fendler, Karim Fizazi, Andrei Gafita, Silke Gillessen, Karolien Goffin, Boris Hadaschik, Michael S Hofman, Thomas A Hope, Tobias Maurer, Alicia K Morgans, Michael J Morris, Declan G Murphy, Daniela E Oprea-Lager, Piet Ost, Joe M ÓSullivan, Olivier Rouvière, Shahneen Sandhu, Oliver Sartor, Mike Machaba Sathekge, Clare Tempany, Wim Witjes, Louise Emmett, Anders S Bjartell
Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK) University Hospital Essen, Essen, Germany., Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France., Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK., Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, Bon Secours Hospital, Cork, Ireland., Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles UCLA, Los Angeles, CA, USA., Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany., Nuclear Medicine Division, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Department of Cancer Medicine, Centre Oscar Lambret, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France., Johns Hopkins Theranostics Center, Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera, Italiana, Lugano, Switzerland., Nuclear Medicine & Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; Nuclear Medicine, University Hospital Leuven, Leuven, Belgium., German Cancer Consortium (DKTK) University Hospital Essen, Essen, Germany; Department of Urology, University of Duisburg-Essen, Essen, Germany., Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia., Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA., Department of Urology and Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands., Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Iridium Network, Radiation Oncology, Wilrijk, Belgium., Patrick G Johnston Centre for Cancer Research, Queen's University, Belfast, UK., Department of Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France., Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia., Department of Medical Oncology, Tulane University, New Orleans, LA, USA., Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa; Nuclear Medicine Research Infrastructure (NuMeRI), Pretoria, South Africa., Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA., European Association of Urology Research Foundation, Arnhem, The Netherlands., Theranostics and Nuclear Medicine Department, St Vincent's Hospital Sydney, Sydney, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia., Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Medical Faculty, Lund University, Lund, Sweden. Electronic address: .