Qing-Rui Li, Yin-Nan Diao, Meng Liu
Skeletal metastasis is a common complication of advanced malignancies, and positron emission tomography/computed tomography (PET/CT) plays an increasingly important role in its diagnosis and management. Given the rapid evolution of this field over the past decade, a timely bibliometric assessment is warranted to delineate its research landscape and emerging trends. This study aimed to comprehensively analyze the global research landscape of PET/CT in skeletal metastasis from 2016 to 2025. Publications were retrieved from the Web of Science Core Collection on April 6, 2026, using a topic search strategy. After screening, 1,154 articles and reviews in English were included. Bibliometric analyses were performed using VOSviewer, CiteSpace, and Scimago Graphica. Annual publication output showed a fluctuating growth trend, peaking in 2025 with 137 papers. China ranked first in publication volume (297 papers), followed by the United States (230 papers) and Germany (150 papers). In terms of citation impact, the United States had the highest total citations (7,628), while the Netherlands achieved the highest average citations per paper (56.7). The European Journal of Nuclear Medicine and Molecular Imaging was the most productive and most cited journal. International collaboration was strongest among the United States, Germany, and the United Kingdom. The included literature covered a broad range of PET tracers, including prostate-specific membrane antigen (PSMA)-targeted agents, choline analogs, fibroblast activation protein inhibitor (FAPI), and somatostatin receptor (SSTR)-targeted tracers. Research hotspots evolved from early validation of novel tracers (68Ga-PSMA, 18F-choline) to PSMA-targeted theranostics and multi-target precision imaging, and more recently to FAPI-based imaging, neuroendocrine tumors, whole-body assessment, and treatment efficacy monitoring. Emerging topics include clinical translation of novel probes, cross-cancer applications, quantitative radiomics, and international collaboration. This evolution indicates that PET/CT research in skeletal metastasis has been moving steadily toward multi-target, cross-cancer, integrated theranostic precision medicine.