PSMA PET/CT improves precision diagnosis, treatment, and clinical decision-making in prostate cancer

Prostate cancer is one of the most prevalent malignancies in males worldwide. Its diagnosis and treatment have long faced challenges, including inaccurate disease staging, difficulty in localizing recurrence sites, and a lack of evidence for individualized decision-making. Recently, prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) technology has emerged as a major breakthrough in addressing these limitations. This review systematically summarizes the technical principles and clinical applications of PSMA PET/CT, and evaluates its impact on diagnostic and therapeutic paradigms of prostate cancer, including its role in precision staging for high-risk patients at initial diagnosis, early localization of biochemical recurrence sites, target delineation for radical therapy, screening of oligometastatic patients for targeted metastatic treatment, as well as its central function in integrated diagnosis and treatment. In addition, this review discusses current limitations of the technology, including inconsistent interpretation standards and controversies over health economics. Future perspectives are also outlined, focusing on the development of novel tracers, the integration of artificial intelligence, and multidisciplinary collaboration. Through the integration of a large amount of clinical research data, this review aims to demonstrate the transformative value of PSMA PET/CT in the diagnosis and treatment of prostate cancer, and to provide evidence-based support for clinical practice and future guideline updates.