Matteo Bauckneht, Laura Evangelista, Luca Sofia, Marco Maccauro, Angelina Filice, Maria Luisa De Rimini, Orazio Caffo, Carlo Messina, Marco Maruzzo, Giada Pinterpe, Marco Krengli, Andrea Mari, Riccardo Schiavina, Sergio Bracarda, Rolando Maria D’Angelillo, A. Lapini, Paolo Andrea Zucali, Giuseppe Fornarini, PSMA PET Italian Survey Collaborators, Raffaela Abate, Domenico Albano, Andrea Alberti, Simona Allis, Filippo Alongi, Pierpaolo Alongi, Francesca Ambrosini, Luca Antonelli, Filippo Antonica, Gabriella Arena, Demetrio Aricò, Francesco Atzori, Marco Badalamenti, Cinzia Baiocco, Valentina Baldazzi, A. Baldoncini, Michelangelo Bambaci, Gian Franco Bardino, Lilia Bardoscia, Lucia Barsacchi, Domenico Barzaghi, Umberto Basso, Antonino Battaglia, Glauco Bertello, Andrea Bianchi, Gabriele Bignante, Michele Boero, Monica Boitano, Amedeo Bonfiglio, Simona Borghesi, Paolo Borghetti, Eugenio Borsatti, Nicolò Borsellino, Roberto Bortolus, Valentina Borzillo, Isa Bossi Zanetti, Annalisa Bramati, Tommaso Brancato, Alessio Bruni, Michele Bruno, G Brusasco, Lorenza Bruschieri, Alberto Buffoli, Luca Burroni, Giovanni Busacca, Sebastiano Buti, Emanuela Cagna, Fabio Calabrò, Natale Daniele Calandruccio, Carmelo Caldarella, Oriana Calisto, Davide Campobasso, Giuseppe Candita, Domenico Cante, Tommaso Carfagno, Paolo Carlini, Paola Caroli, Lucio Carozzi, Giuseppe Carrieri, Salvatore Carrozza, Michele Caruso, Emanuele Casciani, Claudia Caserta, Angelo Castello, Alessandra Castelluccia, Calogero Casà, S. Cauda, Alessia Cavo, Francesco Ceci, Greta Celesti, Rita Cengarle, Linda Cerbone, Valentina Ceriani, Giuseppe Chiacchio, Francesco Chierigo, Angelo Andrea Chirillo, Stefano Ciccarelli, Cosimo Ciotta, Edoardo Cisero, Angelina Cistaro, Alessandra Cocchi
Abstract Background Prostate-specific membrane antigen PET/CT (PSMA PET/CT) has become a cornerstone in the imaging of prostate cancer (PCa), supported by growing evidence and international guideline endorsements. However, real-world adoption and clinical integration of PSMA PET/CT in Italy remain poorly characterised. Methods A multidisciplinary national cross-sectional survey was developed and distributed between November 4–29, 2024, with endorsement from six major Italian scientific societies. The survey included 93 questions addressing availability, technical aspects, clinical use across disease phases, and professional practices. Separate sections were tailored to clinicians and nuclear medicine physicians. Results A total of 238 validated responses were analysed (169 clinicians, 69 nuclear medicine physicians). Nuclear medicine respondents were affiliated mainly with high-volume centres, while clinicians reported greater variability in institutional access. PSMA PET/CT was perceived as insufficiently available by 58% of clinicians at the institutional level, with 36.1% stating that waiting times led to changes in imaging strategy. [ 68 Ga]Ga-PSMA-11 was the preferred tracer among clinicians (57.4%), while nuclear medicine physicians expressed more balanced preferences driven by logistics. Divergent views also emerged regarding the clinical relevance of biodistribution differences. For primary staging, PSMA PET/CT was used by 50% of clinicians for high-risk patients and by 20% for intermediate-risk patients, whereas 87% of nuclear medicine physicians identified PSMA PET/CT as the optimal imaging modality for intermediate-to-high-risk PCa. In cases of discordant imaging findings, multidisciplinary discussion was the preferred strategy for resolution. Conclusion Access to, usage of, and perceptions about PSMA PET/CT differ between clinicians and nuclear medicine physicians, highlighting the need for improved availability and enhanced interdisciplinary coordination.