{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:23:53Z","timestamp":1792844633633,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["EJNMMI Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Accurate staging is essential for optimal management of prostate cancer. Conventional imaging with computed tomography and bone scintigraphy has limited sensitivity and specificity, particularly for small-volume disease. Prostate-specific membrane antigen positron emission tomography\/computed tomography (PSMA-PET\/CT) has emerged as a more sensitive modality, but its impact on clinical decision-making in primary staging remains to be fully defined. In this retrospective single-center study, we evaluated the impact of PSMA-PET\/CT on treatment strategies compared with conventional imaging in patients with intermediate- and high-risk prostate cancer at Sk\u00e5ne University Hospital, Sweden, between October 2020 and December 2022. All patients underwent [\n                      <jats:sup>18<\/jats:sup>\n                      F]PSMA-1007 PET\/CT, computed tomography and bone scintigraphy within 90 days. Management decisions were assessed by comparing treatment decisions based on conventional imaging alone with those incorporating PSMA-PET\/CT findings, and were classified as major (shift between curative and non-curative treatment intent), medium (modification of surgical or radiotherapy plans without altering overall treatment intent), and minor (additional investigations or minor adjustments resulting in treatment delay without change of intent or modality).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 287 consecutive patients were included, of whom 59 (21%) had intermediate-risk and 228 (79%) high-risk disease. Overall, 187 patients (65%) had negative findings on all imaging modalities, while 100 (35%) had positive findings. PSMA-PET\/CT identified lesions in 94 patients, whereas only 6 patients had positive findings exclusively on conventional imaging. PSMA-PET\/CT led to a change in clinical management in 65 patients (22.6%), including major changes in 31 (10.8%), medium changes in 28 (9.9%), and minor changes in 6 (2.1%). Among patients with positive PSMA-PET\/CT findings (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200994), 32.0% experienced major, 29.8% medium and 5.2% minor treatment modifications. Management changes were more frequent in high-risk patients (24.6%) compared to intermediate-risk patients (15.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PSMA-PET\/CT provides actionable information that leads to changes in clinical management in approximately one in four patients undergoing primary staging of prostate cancer, with the greatest impact observed in high-risk disease. These findings support the integration of PSMA-PET\/CT into routine staging to enable more precise and individualized treatment planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13550-026-01480-2","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:55:39Z","timestamp":1782845739000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of PSMA-PET\/CT on clinical decision-making in primary staging of prostate cancer"],"prefix":"10.1186","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7372-2598","authenticated-orcid":false,"given":"Jacob","family":"Ingvar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Tr\u00e4g\u00e5rdh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Bjartell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"issue":"4","key":"1480_CR1","doi-asserted-by":"publisher","first-page":"100993","DOI":"10.1016\/j.currproblcancer.2023.100993","volume":"47","author":"Y Reina","year":"2023","unstructured":"Reina Y, Villaquiran C, Garcia-Perdomo HA. Advances in high-risk localized prostate cancer: Staging and management. Curr Probl Cancer. 2023;47(4):100993.","journal-title":"Curr Probl Cancer"},{"issue":"1","key":"1480_CR2","first-page":"17","volume":"73","author":"RL Siegel","year":"2023","unstructured":"Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17\u201348.","journal-title":"CA Cancer J Clin"},{"issue":"5","key":"1480_CR3","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1111\/bju.16872","volume":"136","author":"J Carll","year":"2025","unstructured":"Carll J, Shi W, Perera M, Lawrentschuk N, Chengodu T, Woon D. Guideline of guidelines: PSMA PET in staging newly diagnosed intermediate-risk prostate cancer. BJU Int. 2025;136(5):800\u20134.","journal-title":"BJU Int"},{"issue":"11","key":"1480_CR4","doi-asserted-by":"publisher","first-page":"469","DOI":"10.6004\/jnccn.2025.0052","volume":"23","author":"DE Spratt","year":"2025","unstructured":"Spratt DE, Srinivas S, Adra N, Ahmed B, An Y, Bitting R, et al. Prostate Cancer, Version 3.2026, NCCN Clinical Practice Guidelines In Oncology. J Natl Compr Canc Netw. 2025;23(11):469\u201393.","journal-title":"J Natl Compr Canc Netw"},{"issue":"7","key":"1480_CR5","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1007\/s12094-022-02784-0","volume":"24","author":"J Orcajo-Rincon","year":"2022","unstructured":"Orcajo-Rincon J, Munoz-Langa J, Sepulveda-Sanchez JM, Fernandez-Perez GC, Martinez M, Noriega-Alvarez E, et al. Review of imaging techniques for evaluating morphological and functional responses to the treatment of bone metastases in prostate and breast cancer. Clin Transl Oncol. 2022;24(7):1290\u2013310.","journal-title":"Clin Transl Oncol"},{"issue":"8","key":"1480_CR6","first-page":"1356","volume":"46","author":"E Even-Sapir","year":"2005","unstructured":"Even-Sapir E. Imaging of malignant bone involvement by morphologic, scintigraphic, and hybrid modalities. J Nucl Med. 2005;46(8):1356\u201367.","journal-title":"J Nucl Med"},{"issue":"4","key":"1480_CR7","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.crad.2007.05.022","volume":"63","author":"AM Hovels","year":"2008","unstructured":"Hovels AM, Heesakkers RA, Adang EM, Jager GJ, Strum S, Hoogeveen YL, et al. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol. 2008;63(4):387\u201395.","journal-title":"Clin Radiol"},{"issue":"2","key":"1480_CR8","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.eururo.2025.05.006","volume":"88","author":"E Mazzone","year":"2025","unstructured":"Mazzone E, Thomson A, Chen DC, Cannoletta D, Quarta L, Pellegrino A, et al. The Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Assessment of Local Recurrence and Distant Metastases in Patients with Biochemical Recurrence of Prostate Cancer After Definitive Treatment: A Systematic Review and Meta-analysis. Eur Urol. 2025;88(2):129\u201341.","journal-title":"Eur Urol"},{"issue":"10231","key":"1480_CR9","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1016\/S0140-6736(20)30314-7","volume":"395","author":"MS Hofman","year":"2020","unstructured":"Hofman MS, Lawrentschuk N, Francis RJ, Tang C, Vela I, Thomas P, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet. 2020;395(10231):1208\u201316.","journal-title":"Lancet"},{"issue":"4","key":"1480_CR10","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.eururo.2019.01.049","volume":"77","author":"M Perera","year":"2020","unstructured":"Perera M, Papa N, Roberts M, Williams M, Udovicich C, Vela I, et al. Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer-Updated Diagnostic Utility, Sensitivity, Specificity, and Distribution of Prostate-specific Membrane Antigen-avid Lesions: A Systematic Review and Meta-analysis. 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Semin Nucl Med. 2023;53(5):706\u201318.","journal-title":"Semin Nucl Med"}],"container-title":["EJNMMI Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13550-026-01480-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13550-026-01480-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13550-026-01480-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:58:21Z","timestamp":1782845901000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13550-026-01480-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1480"],"URL":"https:\/\/doi.org\/10.1186\/s13550-026-01480-2","relation":{},"ISSN":["2191-219X"],"issn-type":[{"value":"2191-219X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"6 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Regional Ethics Committee in Lund (2016\/417, 2018\/117, 2018\/753, 2020\u201302524) and all patients signed informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Patients signed informed consent regarding publishing their data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No financial interest or benefit related to this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Competing interests"}}],"article-number":"103"}}