{"entity":{"id":"psma-rads","kind":"term","name":"PSMA-RADS (PSMA reporting and data system)","aka":[],"tldr":"A standard 1-to-5 scale that nuclear medicine doctors use to describe how likely a spot seen on a PSMA PET scan is to be prostate cancer, so different hospitals describe the same finding the same way.","summary":"PSMA-RADS version 1.0, proposed by Rowe, Pienta, Pomper and Gorin at Johns Hopkins in 2017-2018, is a structured reporting system for PSMA-targeted PET imaging modelled on other \"reporting and data systems\" such as BI-RADS. It assigns each lesion a category from 1 (benign, subdivided into 1A without uptake and 1B with uptake but known-benign) through 2 (likely benign, low-level uptake atypical for prostate cancer), 3A/3B/3C/3D (equivocal, warranting further work-up such as biopsy or 3-6 month follow-up imaging), 4 (intense uptake typical of prostate cancer but without a corresponding finding on conventional imaging) to 5 (intense uptake with a corresponding conventional-imaging finding, prostate cancer almost certainly present). Reports give up to five target lesions a PSMA-RADS category plus an overall scan score equal to the highest individual lesion score.\n\nInterobserver agreement studies on 18F-DCFPyL PET/CT found good-to-excellent agreement (intraclass correlation coefficients of 0.60-0.84 depending on lesion type), supporting its reproducibility across readers. A revised PSMA-RADS 2.0 has since been proposed, folding the 1A/1B split into a single benign category, allowing PSMA-RADS 3A/3B/3D lesions to be reclassified as 4 in patients with widespread metastatic disease, and adding a 5T subcategory for effectively treated metastases after systemic prostate cancer therapy.\n\nThe system is complementary to PSMA PET-guided treatment decisions (for example selecting patients for lutetium-177 or actinium-225 PSMA radioligand therapy) but is not itself a treatment-eligibility threshold; eligibility criteria used in trials such as VISION relied on separate PSMA-positivity rules.","asOf":"2026-09-22","links":[{"label":"Rowe SP, Pienta KJ, Pomper MG, Gorin MA. Proposal for a Structured Reporting System for PSMA-Targeted PET Imaging: PSMA-RADS Version 1.0. J Nucl Med 2018;59:479-485","url":"https://jnm.snmjournals.org/content/jnumed/59/3/479.full.pdf"},{"label":"Werner RA, et al. Interobserver Agreement for PSMA-RADS 1.0 on 18F-DCFPyL PET/CT. J Nucl Med (2018)","url":"https://jnm.snmjournals.org/content/jnumed/early/2018/09/06/jnumed.118.217588.full.pdf"},{"label":"PSMA-RADS: updated version 2.0 discussion (PMC, 2023)","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11981304/"}],"tags":["reporting system","PSMA PET","structured reporting"],"related":["psma-pet","psma","ga68-psma-11","pylarify","pluvicto","prostate-mcrpc","vision","f-18","lu-177","ac-225"],"indications":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"imaging"},"route":"/terms/psma-rads/","neighbours":{"technology":[{"id":"psma-pet","kind":"technology","name":"PSMA PET","route":"/technologies/psma-pet/"}],"target":[{"id":"psma","kind":"target","name":"PSMA","route":"/targets/psma/"}],"drug":[{"id":"ga68-psma-11","kind":"drug","name":"Gallium-68 gozetotide (PSMA-11)","route":"/drugs/ga68-psma-11/"},{"id":"pluvicto","kind":"drug","name":"Lutetium-177 vipivotide tetraxetan","route":"/drugs/pluvicto/"},{"id":"pylarify","kind":"drug","name":"Piflufolastat F-18 / Pylarify TruVu","route":"/drugs/pylarify/"}],"indication":[{"id":"prostate-mcrpc","kind":"indication","name":"Metastatic castration-resistant prostate cancer","route":"/indications/prostate-mcrpc/"}],"trial":[{"id":"vision","kind":"trial","name":"VISION","route":"/trials/vision/"}],"isotope":[{"id":"ac-225","kind":"isotope","name":"Actinium-225","route":"/isotopes/ac-225/"},{"id":"f-18","kind":"isotope","name":"Fluorine-18","route":"/isotopes/f-18/"},{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"}],"term":[{"id":"tumour-to-background-ratio","kind":"term","name":"Tumour-to-background ratio (TBR)","route":"/terms/tumour-to-background-ratio/"}]}}