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Introduction of an Integrated Pathology Image Management, Artificial Intelligence, and Reporting System
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Standardizing PSMA PET/CT reporting in prostate cancer: from structured frameworks to AI-assisted interpretation.

Yuki Arita1,2,3, Xinlin Zheng4, Fang Wen5

  • 1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA. yukiarita1113@gmail.com.

Abdominal Radiology (New York)
|June 19, 2026
PubMed
Summary
This summary is machine-generated.

Standardizing prostate cancer staging with PSMA PET/CT is crucial. This article proposes a pragmatic workflow using PROMISE V2 and PSMA-RADS, enhanced by AI, to improve reporting consistency and clinical decisions.

Keywords:
Molecular imaging TNMPET/CTPROMISEPSMAPSMA-RADSProstate cancerStructured reporting

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Area of Science:

  • Nuclear Medicine
  • Radiology
  • Oncology

Background:

  • Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) is vital for prostate cancer management.
  • Standardized interpretation frameworks like PROMISE V2 and PSMA-RADS 2.0 exist but face challenges in real-world adoption.
  • Heterogeneous reporting complicates communication and decision-making.

Purpose of the Study:

  • To propose a pragmatic interpretation workflow for PSMA PET/CT.
  • To address challenges in current reporting practices and framework adoption.
  • To integrate emerging AI tools into a physician-supervised reporting process.

Main Methods:

  • Development of a clinical question-driven approach to framework selection.
  • Implementation of a compartment-based search pattern and minimal synoptic reporting template.
  • Guidance on common pitfalls, tracer-specific issues, and AI-assisted reporting.

Main Results:

  • A proposed workflow standardizes impressions with PROMISE V2 staging and uses PSMA-RADS for equivocal lesions.
  • Minimal synoptic templates improve reporting consistency.
  • Physician-supervised AI tools can aid lesion detection, quantification, and longitudinal matching.

Conclusions:

  • A standardized, pragmatic workflow enhances PSMA PET/CT interpretation for prostate cancer.
  • Integration of PROMISE V2, PSMA-RADS, and AI tools improves reporting quality and clinical utility.
  • Addressing real-world challenges is key to optimizing PSMA PET/CT reporting.