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Updated: Jun 20, 2026
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Introduction of an Integrated Pathology Image Management, Artificial Intelligence, and Reporting System
Published on: July 11, 2025
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
Summary
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.
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.
