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Fluorine-18 prostate-specific membrane antigen (18F-PSMA) refers to a class of diagnostic radiopharmaceuticals used in positron emission tomography (PET) imaging for the detection, staging, and characterization of prostate cancer. These agents consist of a targeting ligand—typically a urea-based small molecule with high affinity for the extracellular domain of prostate-specific membrane antigen (PSMA)—labeled with the positron-emitting radioisotope fluorine-18 (18F). PSMA is highly overexpressed on the cell surface of most prostate cancer cells, particularly in high-grade, metastatic, and castration-resistant diseases. Compared to gallium-68 (68Ga) labeled PSMA tracers, 18F-labeled agents offer superior physical properties, including a longer half-life (110 minutes vs. 68 minutes) that permits centralized production and regional distribution, and a lower positron energy that yields higher spatial resolution and improved detection of small lesions. Several specific 18F-PSMA tracers have been developed and approved, including piflufolastat F-18 (Pylarify), flotufolastat F-18 (Posluma), and 18F-PSMA-1007.
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