30-Second Takeaway
- Quantitative PSMA PET and PROMISE criteria now inform prostate cancer prognosis and postprostatectomy risk discussions.
- Preoperative intraprostatic PSMA SUVmax >10 signals higher metastatic risk after robot-assisted radical prostatectomy.
- New tracers targeting VAP-1, PARP1, c-Met, and CA-IX broaden oncologic and inflammatory imaging beyond FDG.
- ImmunoPET, innervation imaging, and ML on FDG PET deepen phenotyping of immune, neural, and neurodegenerative disease.
- PET/SPECT are increasingly central to drug development, quantifying target engagement, PK/PD, and early response.
Week ending December 27, 2025
Precision PET and SPECT tracers to refine oncologic risk, inflammation, and systems imaging
PSMA PET and PROMISE framework for prostate cancer risk stratification
This review details how PSMA PET has become central to staging and restaging prostate cancer. It summarizes evidence that PSMA PET–derived biomarkers provide noninvasive risk assessment and predict clinical outcomes. The PROMISE criteria offer a standardized framework linking PSMA PET findings with overall survival associations. Clinically, applying PROMISE-based reporting may refine treatment selection, follow-up intensity, and patient counseling on prognosis.
Intraprostatic PSMA SUVmax >10 predicts metastases after RARP
This two-centre retrospective cohort included 293 men with nonmetastatic prostate cancer undergoing preoperative PSMA PET/CT before robot-assisted radical prostatectomy. Over median 39 months, 53 patients developed metastases detected by PSMA PET/CT at biochemical recurrence. Higher preoperative dominant-lesion SUVmax independently predicted metastatic progression, even after adjusting for standard clinical variables. An SUVmax threshold >10 was associated with higher metastatic risk, supporting its use for preoperative risk stratification. Nonstandardized imaging follow-up and treatment decisions introduce selection and detection biases when extrapolating to management changes.
VAP-1–targeted [68Ga]DOTA-Siglec-9 PET visualizes pulmonary and systemic sarcoidosis
Six patients with stage 2 pulmonary sarcoidosis and matched controls underwent [68Ga]DOTA-Siglec-9 PET/CT targeting VAP-1. Sarcoidosis patients showed significantly higher lung uptake than controls, with SUVmean approximately fourfold higher. Mediastinal lymph nodes also demonstrated significantly increased uptake versus controls. Liver, spleen, bone marrow, and bone showed elevated uptake, suggesting systemic inflammatory involvement. These proof-of-concept data support further evaluation of VAP-1 PET for sarcoidosis burden and activity assessment.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.