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. 2025 Nov;175(2):713-720.
doi: 10.1007/s11060-025-05167-x. Epub 2025 Jul 31.

Is 18F-PSMA PET/CT a reliable imaging modality to evaluate the status of recurrent/residual brain tumors in post-treatment patients?

Tarun Kumar Jain  1 , Mansha Vohra  2 , Bhawani Shanker Sharma  3 , Anushree Loyal  4 , Priya Sharma  2 , Patel Meet  2 , Shikha Dhal  4 , Vineet Mishra  5 , Jitendra Singh Verma  4 , Surabhi Tyagi  6 , Hemant Malhotra  7
Affiliations

Is 18F-PSMA PET/CT a reliable imaging modality to evaluate the status of recurrent/residual brain tumors in post-treatment patients?

Tarun Kumar Jain et al. J Neurooncol. 2025 Nov.

Abstract

Background: Brain tumors are the most challenging malignancies. The existing investigational and treatment modalities have a few drawbacks with high rate of recurrence / residual tumoral tissue. Positron Emitting Tomography combined with computed tomography (PET-CT) is a widely used imaging modality for oncology and non-oncological purposes with fluorine-18-floruodeoxyglucose (18 F-FDG) being the most familiar radiotracer. Physiological uptake of FDG in brain parenchyma makes it a challenging task to currently delineate the residual/ recurrent brain tumors which brings us to investigate new radiotracers.

Objective: The purpose of present study is to identify the role of 18 fluoride labelled Prostate Specific Membrane Antigen (PSMA) in residual recurrent brain malignancies and compared the PSMA PET-CT scan with standard conventional imaging in same purpose.

Methods: This was a prospective study and patients were enrolled after underwent treatment (surgery and /or concurrent chemoradiotherapy). In order to detection of the residual recurrent disease, 18 F PSMA PET-CT as well as conventional imaging modalities were performed. We calculated the diagnostic performance of the PSMA PET-CT and also compared with standard conventional imaging modalities.

Results: Thirty-one patients were included in the study. Out of 31 patients, 23 (~ 74.2%) patients were positive on PSMA PET-CT scan and 18 (~ 58.06%) were on conventional imaging (CI) for residual recurrent mitotic disease. The calculated sensitivity, specificity, PPV, NPV and diagnostic yields for PSMA PET-CT and CI were 96%, 88%, 96%, 88% and 93.5% and 83%, 50%, 83%, 50% and 74.2% respectively. In our study, among 31 patients, 22 patients underwent MRI imaging in form of convention imaging and calculated sensitivity, specificity, PPV, NPV and diagnostic yields for MRI was 81%, 42.85%, 76.5%, 50% and 77.3% respectively. Among these 22 patients, MRI with PSMA PET-CT scan was discordant in 7 patients (27.3%).

Conclusion: 18 F-PSMA PET-CT imaging has higher diagnostic yield then existing conventional diagnostic modalities with capability to rule out extracranial lesions and inherent-potential of being utilised as theragnostic moiety.

Keywords: 18F-PSMA 1007 PET-CT; Brain tumours; Conventional imaging; MRI; Neovascularisation; Prostate specific membrane antigen; Residual recurrent lesion.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Conflict of interest: The authors declare that there is no conflict of interest. Informed consent: Written informed consent was taken from the patients.

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