{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:04:56Z","timestamp":1788599096850,"version":"build-2803163510"},"reference-count":111,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT), and whole-body magnetic resonance imaging (WB-MRI) are superior to conventional CT and bone scan imaging for detecting metastatic disease in patients with prostate cancer. While these higher-accuracy imaging methods have already shown the potential to enhance patient outcomes, a thorough understanding of the relationship between the treatment landscape and disease volume on conventional imaging, as well as the prognostic significance of the prostate-specific antigen response, is crucial for determining how they can be more effectively incorporated. Prospective clinical trials are required to evaluate whether PSMA-PET\/CT and WB-MRI can genuinely improve clinically relevant endpoints for patients through precise treatment adaptations. In this paper, we explore the specific opportunities of PSMA-PET\/CT and WB-MRI as biomarkers in multiple clinical domains, including metastasis detection and staging, disease characterisation and aggressiveness assessments, biopsy target selection, impacts on treatment planning, evaluation of therapeutic response, and theranostics. We highlight the central research questions that require attention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Can PSMA-PET\/CT and WB-MRI, with their superior ability to detect metastases in prostate cancer, truly improve patient outcomes?<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>High-accuracy imaging improves metastasis detection, staging, assessment of disease aggressiveness, and enables more personalised treatment planning for advanced prostate cancer patients.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>PSMA-PET\/CT and WB-MRI have the potential to alter the management of men with advanced prostate cancer, but prospective clinical trials are needed to confirm benefits for survival or quality of life before recommending routine use.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-12089-9","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:33:40Z","timestamp":1762360420000},"page":"2794-2812","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["ESUR: Opportunities for PSMA-PET\/CT and whole-body MRI in advanced prostate cancer"],"prefix":"10.1007","volume":"36","author":[{"given":"Sungmin","family":"Woo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Withey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailin","family":"Dehghanpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Garc\u00eda-Figueiras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo 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Padhani.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"I.G.S. is co-chair of the PI-RADS steering committee, a full panel member of the European Association of Urology PCa guidelines. T.P. is funded in part by the Berlin Institute of Health (BIH) and receives funding from Berlin Institute of Health (Advanced Clinician Scientist Grant, Platform Grant), Ministry of Education and Research (BMBF, 01KX2021 (RACOON), 01KX2121 (\u201cNUM 2.0\u201c, RACOON), 68GX21001A, 01ZZ2315D), German Research Foundation (DFG, SFB 1340\/2), European Union (H2020, CHAIMELEON: 952172, DIGITAL, EUCAIM:101100633). T.P. also declares relationships with the following companies: research agreements (no personal payments) with AGO, Aprea AB, ARCAGY-GINECO, Astellas Pharma Global Inc. (APGD), Astra Zeneca, Clovis Oncology, Inc., Holaira, Incyte Corporation, Karyopharm, Lion Biotechnologies, Inc., MedImmune, Merck Sharp & Dohme Corp, Millennium Pharmaceuticals, Inc., Morphotec Inc., NovoCure Ltd., PharmaMar S.A. and PharmaMar USA, Inc., Roche, Siemens Healthineers, and TESARO Inc., fees for a book translation (Elsevier B.V.), fees for speaking engagements (Bayer Healthcare). J.W. reports grants\/contracts from Exact Imaging; and personal\/consulting and\/or advisory fees\/honoraria from A3P, AAA\/Novartis, ANNA\/C-TRUS, Astellas Pharma Europe, AstraZeneca, Bayer, Blue Earth Diagnostics, BXTA, Curium US LLC, Intuitive Surgical, Ipsen, Janssen Cilag EAME, Lightpoint Medical, Lucida, Telix, and Veracyte Inc. M.E. reports research funding from Blue Earth Diagnostics and Bayer, patent application for rhPSMA; consulting fees from Blue Earth Diagnostics, Novartis\/Advanced Accelerator Applications, Telix Pharmaceuticals, Bayer, RayzeBio, Point Biopharma, and Janssen Pharmaceuticals; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Novartis\/Advanced Accelerator Applications, Janssen Pharmaceuticals, Blue Earth Diagnostics, Bayer, and Eckert & Ziegler; fees for image review for Parexel and Bioclinica; payment for expert testimony from Blue Earth Diagnostics, Novartis, Telix Pharmaceuticals, and Bayer; support for attending meetings and\/or travel from Blue Earth Diagnostics; participation on a data and safety monitoring board or advisory board for Blue Earth Diagnostics, Novartis, Telix Pharmaceuticals, and Bayer; and leadership or fiduciary role for the European Association of Nuclear Medicine. W.P.F. reports fees from SOFIE Bioscience (research funding), Janssen (consultant and speaker), Perceptive (consultant and image review), Bayer (consultant, speaker, and research funding), Novartis (speaker and consultant), Telix (speaker), GE Healthcare (speaker and consultant), Eczac\u0131ba\u015f\u0131 Monrol (speaker), Abx (speaker), Amgen (speaker), Urotrials (speaker), and Lilly (consultant). S.G. received personal honoraria for participation in advisory boards for Sanofi, Orion, Roche, Amgen, and MSD; received other honoraria from RSI (Televisione Svizzera Italiana); is an invited speaker for ESMO, Swiss group for Clinical Cancer Research (SAKK), Swiss Academy of Multidisciplinary oncology (SAMO), Orikata academy research group, and the China Anti-Cancer Association Genitourinary Oncology Committee (CACA-GU); is a member of the Speaker\u2019s bureau for Janssen Cilag; received a travel grant from ProteoMEdiX; received institutional honoraria for advisory boards for Bayer, Janssen Cilag, Roche, AAA International including Indipendent Data Monitoring Committee and IDMC and Steering Committee member for Amgen, Menarini Silicon Biosystems, Astellas Pharma, Tolero Pharmaceutcials, MSD, Pfizer, Telixpharma, BMS, and Orion; received patent royalties and other intellectual property for a research method for biomarker WO2009138392. R.P.L. declares research funding by AstraZeneca and Roche; she participates in the steering committee of a clinical trial sponsored by Roche. F.L. is a consultant, has received a research grant, and is on the speakers\u2019 bureau of GE HealthCare. T.D.B. received speaker fees from Bayer. A.R.P. declares stock options in Lucida Medical. Research agreements with Lucida Medical and Siemens Healthineers. The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}