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PSMA-RADS 2.0: clinical validation and technical considerations for prostate-specific membrane antigen positron emission tomography/computed tomography image interpretation.

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Quantitative imaging in medicine and surgery 📖 저널 OA 100% 2022: 1/1 OA 2023: 8/8 OA 2024: 9/9 OA 2025: 49/49 OA 2026: 46/46 OA 2022~2026 2026 Vol.16(2) p. 172
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Cheng L, Jin C, Zhang H, Sun Z, Fan J, Yang T, Mao F, Fu G, Wang Q, Niu X, Tao W

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[BACKGROUND] The updated diagnostic framework prostate-specific membrane antigen Reporting and Data System 2.0 (PSMA-RADS 2.0) has been introduced as a standardized scoring system for PSMA positron em

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APA Cheng L, Jin C, et al. (2026). PSMA-RADS 2.0: clinical validation and technical considerations for prostate-specific membrane antigen positron emission tomography/computed tomography image interpretation.. Quantitative imaging in medicine and surgery, 16(2), 172. https://doi.org/10.21037/qims-2025-1928
MLA Cheng L, et al.. "PSMA-RADS 2.0: clinical validation and technical considerations for prostate-specific membrane antigen positron emission tomography/computed tomography image interpretation.." Quantitative imaging in medicine and surgery, vol. 16, no. 2, 2026, pp. 172.
PMID 41669484 ↗

Abstract

[BACKGROUND] The updated diagnostic framework prostate-specific membrane antigen Reporting and Data System 2.0 (PSMA-RADS 2.0) has been introduced as a standardized scoring system for PSMA positron emission tomography/computed tomography (PET/CT) structured reporting to enhance the accuracy and clinical utility of prostate cancer (PCa) lesion interpretation. This study aims to evaluate the reliability and identify potential limitations of PSMA-RADS 2.0 in clinical applications.

[METHODS] We conducted a comparative analysis between PSMA-RADS versions 1.0 and 2.0, followed by prospective evaluation of 109 lesions using PSMA-RADS 2.0 criteria. Inter- and intra-reader consistencies were analyzed statistically to evaluate the reliability and practicality of the scoring system. In the context of two independent readings, the inter-reader consistency between experienced readers (ERs) and inexperienced readers (IRs) was evaluated using the intra-class correlation coefficient (ICC).

[RESULTS] Compared to version 1.0, PSMA-RADS 2.0 simplified primary PSMA-RADS-1 classification for Category I lesions and introduced PSMA-RADS-5T for post-treatment assessment. Inter-reader correlation coefficients values demonstrated excellent consistency (ERs: 0.964-0.969; IRs: 0.929-0.932). Intra-reader correlation coefficients ranged from 0.920 to 0.985 across all readers. However, challenges persisted in lymph node interpretation (ICC: 0.797-0.823) and post-treatment classification.

[CONCLUSIONS] PSMA-RADS 2.0 provides a reliable framework for PSMA PET/CT interpretation, even for IRs. Further refinement is needed for post-treatment categorization and lymph node differentiation. The proposed PSMA-RADS-5T sub-classification complete remission/partial remission/stability disease/progression disease (CR/PR/SD/PD) may enhance clinical utility for treatment monitoring.

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