A new set of appropriate use criteria is now available to guide referring and imaging physicians in their use of prostate-specific membrane antigen (PSMA) PET imaging agents to detect prostate cancer. The Society of Nuclear Medicine and Molecular Imaging (SNMMI), the American College of Nuclear Medicine, the American Urological Association, the Australia and New Zealand Society of Nuclear Medicine, and the American Society of Clinical Oncology worked collaboratively to develop criteria for the appropriate use of this new imaging technology.

PSMA imaging agents are radioactive tracers that are used with PET scans to detect the presence of the PSMA protein, which is overexpressed in prostate cancer. PSMA PET imaging allows physicians to scan the entire body for PSMA proteins and provides a more detailed depiction of metastatic disease.

“In the past year, the U.S. FDA has approved two PSMA PET imaging agents for the detection of prostate cancer. These agents will soon become more widely available. To be sure these important agents are available for patients, it was essential to develop a set of appropriate use criteria for physicians,” says Richard L. Wahl, MD, FACNM, SNMMI president.

To create the criteria, SNMMI assembled an autonomous PSMA PET Imaging Workgroup representing a multidisciplinary panel of health care providers with substantive knowledge in the use of nuclear medicine procedures in prostate cancer imaging. The workgroup reviewed the scientific literature and developed consensus recommendations for the clinical use of PSMA PET imaging. The Oregon Health Science University Evidence-Based Practice Center then conducted a systematic review of existing evidence based on the scope and parameters from the PSMA PET Imaging Workgroup. The systematic review was used to make recommendations for clinical use.

SNMMI has developed a multipronged approach to disseminate the appropriate use criteria for PSMA PET in prostate cancer to all relevant stakeholders—referring physicians, nuclear medicine physicians, and patients. The dissemination and implementation tactics will be a mix of outreach and educational activities and will be targeted to each of these audiences. In addition to these activities, SNMMI also aims to create a mobile application for the PSMA PET appropriate use criteria for both Apple and Android platforms.

“This new imaging technology is important news for men with both newly diagnosed and suspected recurrence of prostate cancer and will provide a highly accurate diagnosis. We are confident that the appropriate use criteria will be a helpful tool to guide use of this advanced imaging in treatment decisions,” says Wahl.

The PSMA PET Imaging Appropriate Use Criteria are available at www.snmmi.org/auc.