ASSESSING THE DIAGNOSTIC PERFORMANCE OF POSITRON EMISSION TOMOGRAPHY/MAGNETIC RESONANCE IMAGING (PET/MRI) IN PROSTATE CANCER: A SYSTEMATIC REVIEW

Abstract

Background: Prostate cancer is a leading cause of cancer-related morbidity and mortality worldwide. Accurate imaging is essential for diagnosis, staging, and treatment planning. Positron emission tomography/magnetic resonance imaging (PET/MRI) has emerged as a promising hybrid imaging modality combining functional and anatomical information. Objective: To systematically evaluate the diagnostic performance of PET/MRI in prostate cancer detection, staging, and recurrence assessment. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar were searched up to December 2025. Studies assessing PET/MRI in prostate cancer were included. Data on sensitivity, specificity, accuracy, and detection rates were extracted and analyzed using a narrative synthesis approach. Results: Ten studies met the inclusion criteria. PET/MRI demonstrated superior or complementary diagnostic performance compared to mpMRI and PET/CT. Sensitivity for clinically significant prostate cancer reached up to 97% in combined imaging approaches. PET/MRI improved lesion detection, staging accuracy, and negative predictive value, particularly in high-risk and recurrent disease. However, specificity varied across studies, and performance was limited in detecting low-grade tumors. Conclusion: PET/MRI offers significant advantages in prostate cancer imaging, particularly when using PSMA based tracers. It enhances diagnostic accuracy and clinical decision-making, although further standardization and large-scale studies are needed to establish its role in routine practice.