Prostate specific membrane antigen focal ablation imaging (PSMA-FAB)

The Prostate Imaging after Focal Ablation (PI-FAB) score has been recently proposed for scoring the appearance on multiparametric magnetic resonance imaging (mpMRI) of prostate cancer after focal therapy. The progressive implementation of prostate specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) into the management of prostate cancer has revolutionized the diagnostic work-up and inspired our proposal for a dedicated PSMA Focal Ablation Imaging (PSMA-FAB) scoring system. Based on pre- and post-treatment imaging, the classification is categorized into: PSMA-FAB 1 (continue monitoring); PSMA-FAB2 (assess PSA kinetics and MRI, with biopsy to be considered in case of suspicion); and PSMA-FAB 3 (recommend biopsy). Furthermore, a combined Focal-therapy Imaging Response Evaluation Score (FIRE-SCORE) embedding PI-FAB and PSMA-FAB scores is suggested to help patient's management at follow up.