Practical Guide to PSMA PET Radiopharmaceuticals for Prostate Cancer Imaging

No FDA-approved PSMA-targeted PET radiopharmaceutical ([68Ga]Ga-PSMA-11, [18F]DCFPyl, [18F]rhPSMA-7.3) has proven diagnostic superiority for prostate cancer imaging; they differ in clearance routes (renal vs hepatic) and supply logistics, so choice should be guided by operationa…

• This AJR review highlights three FDA-approved PSMA PET agents, noting that despite structural and radioisotope differences, direct comparisons show no overall performance advantage for any single agent.
• Renal versus hepatic clearance patterns may affect lesion detection adjacent to the urinary tract or within the liver, influencing pre-therapy assessment where liver is used as reference.
• Limited intrapatient comparative data exist; radiopharmaceutical selection often hinges on supply reliability, workflow integration, and institutional logistics.

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