Cost-effectiveness of PSMA-PET imaging technology in diagnosing and staging of prostate cancer: a systematic review

Background: Prostate-specific membrane antigen (PSMA) PET is becoming the preferred imaging technique for prostate cancer (PCa) because of its superior sensitivity and specificity compared to traditional imaging methods. This article evaluates the methodological and reporting quality of literature regarding the cost-effectiveness of PSMA-positron emission tomography (PET)/computed tomography (CT) or MRI for detecting and staging PCa. Objective: To describe the methodological and reporting quality of the published cost-effectiveness studies on PSMA-PET. Methods: MEDLINE and EMBASE were searched from inception to December 05, 2025. Two researchers independently screened all retrieved articles according to inclusion and exclusion criteria. Studies were appraised for methodological quality using the Quality of Health Economic Studies checklist and for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards checklist. Results: A total of seven studies were examined, representing both private and public healthcare systems. Overall, these studies demonstrate high methodological and reporting quality. When compared to existing imaging technologies or standard care practices, PSMA-PET/CT or MRI is cost-effective within country-specific willingness-to-pay thresholds. Conclusion: Cost-effectiveness evaluations may not be widely generalizable due to significant variability among geographical regions concerning resource availability, costs, morbidity and mortality, and standards of practice. As PSMA-PET/CT imaging technology becomes more widely available in additional countries in the coming years, we expect to generate more country-specific data.