Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET-CT vs PET-MRI

Feng Yuan Liu, Ting Wen Sheng, Jing Ren Tseng, Kai Jie Yu, Ke Hong Tsui, Se Tong Pang, Li Jen Wang, Gigin Lin

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)


Objectives: To investigate whether PET-CT or PET- MRI is more appropriate for imaging prostate cancer, in terms of primary tumor detection, local staging and recurrence, as well as lymph nodes and distant metastases. Methods: A systematic literature search was conducted on Embase, PubMed/MEDLINE, and the Cochrane Library database. Studies evaluating the diagnostic performance of PET-CT vs PET-MRI in prostate cancer patients were emphasized. Results: We reviewed 57 original research articles during the period 2016-2021: 14 articles regarding the radiotracer PSMA; 18 articles regarding the primary tumor detection, local tumor staging, managing local recurrence; 17 articles for managing lymph node metastases; and eight articles for managing bone and other distant metastases. PSMA PET could be complementary to mpMRI for primary prostate cancer localization and is particularly valuable for PI-RADS three lesions. PET-MRI is better than PET-CT in local tumor staging due to its specific benefit in predicting extracapsular extension in MRI-occult prostate cancer patients. PET-MRI is likely superior as compared with PET-CT in detecting local recurrence, and has slightly higher detection rates than PET-CT in lymph node recurrence. PET-CT and PET- MRI seem to have equivalent performance in detecting distant bony or visceral metastases. Conclusion: In conclusion, PET-MRI is suitable for local and regional disease, either primary staging or restaging, whereas PET-CT is valuable for managing distant bony or visceral metastasis. Advances in knowledge: We reviewed the emerging applications of PET-MRI and PET-CT in clinical aspects. Readers will gain an objective overview on the strength and shortfalls of PET-MRI or PET-CT in the management of prostate cancer.

Original languageEnglish
Article number20210728
JournalBritish Journal of Radiology
Issue number1131
Publication statusPublished - 2022
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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