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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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Published on: November 7, 2025

Role of 18F-PSMA PET/MRI in Prostate Cancer Recurrence After Prostatectomy

Alexandra Paule1,2, Soizic Masson1, Johan Rose Dite Modestine3

  • 1Caribbean Institute of Nuclear Imaging, ICIN, CHU Martinique, Martinique, France.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|June 4, 2026
PubMed

Insights

18F-PSMA PET/MRI is superior for detecting prostate cancer recurrence after surgery. This 1-stop-shop protocol improves detection rates for local recurrences compared to PET/CT and MRI alone.

Area of Science:

  • Nuclear Medicine
  • Radiology
  • Oncology

Background:

  • Biochemical recurrence of prostate cancer post-prostatectomy necessitates accurate detection methods.
  • 18F-PSMA PET/CT and multiparametric MRI (mpMRI) are established tools for assessing recurrence.
  • A combined 1-stop-shop protocol using 18F-PSMA PET/MRI aims to enhance diagnostic accuracy.

Purpose of the Study:

  • To evaluate the efficacy of a novel 1-stop-shop 18F-PSMA PET/MRI protocol for detecting prostate cancer recurrence.
  • To compare the diagnostic performance of 18F-PSMA PET/MRI against 18F-PSMA PET/CT and mpMRI.

Main Methods:

  • 106 patients with biochemical recurrence post-prostatectomy underwent a 1-stop-shop protocol.
  • This protocol included whole-body 18F-PSMA PET/CT and pelvic 18F-PSMA PET/mpMRI after a single tracer injection.
  • Two blinded readers evaluated each imaging modality, with 18F-PSMA PET/MRI serving as the reference standard.

Main Results:

  • 18F-PSMA PET/MRI detected more local recurrences (49.06%) than 18F-PSMA PET/CT (39.62%) and mpMRI (43.00%).
  • Discordant findings were observed in 17% of cases, with positivity on MRI alone (10%) or PSMA PET alone (7%).
  • Compared to 18F-PSMA PET/MRI, mpMRI and 18F-PSMA PET showed similar sensitivities (88.5% and 78.8%) and specificities (100% and 98.1%).

Conclusions:

  • 18F-PSMA PET/MRI demonstrates superior performance in detecting local prostate cancer recurrences compared to PET/CT and mpMRI.
  • The 1-stop-shop protocol offers a comprehensive approach for evaluating biochemical recurrence.
  • This integrated imaging strategy may improve the management of recurrent prostate cancer.
Keywords:
18F-PSMA PET/MRIbiochemical recurrenceprostate cancerprostatectomy

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