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Meta-Analysis
. 2021 Jul-Aug;47(4):705-729.
doi: 10.1590/S1677-5538.IBJU.2019.0817.

68Ga-Prostate-specific membrane antigen (psma) positron emission tomography (pet) in prostate cancer: a systematic review and meta-analysis

Cristina S Matushita  1 , Ana M Marques da Silva  1   2 , Phelipi N Schuck  2 , Matteo Bardisserotto  3 , Diego B Piant  1 , Jonatas L Pereira  4 , Juliano J Cerci  5 , George B Coura-Filho  6 , Fabio P Esteves  7 , Barbara J Amorim  8 , Gustavo V Gomes  9 , Ana Emília T Brito  10 , Wanderley M Bernardo  11 , Eduardo Mundstock  12 , Stefano Fanti  13 , Bruna Macedo  1 , Diego H Roman  1 , Cinthia Scatolin Tem-Pass  12 , Bruno Hochhegger  1
Affiliations
Meta-Analysis

68Ga-Prostate-specific membrane antigen (psma) positron emission tomography (pet) in prostate cancer: a systematic review and meta-analysis

Cristina S Matushita et al. Int Braz J Urol. 2021 Jul-Aug.

Abstract

Introduction: Prostate cancer (PC) is the second most commonly diagnosed cancer in males. 68Ga-PSMA PET/CT, a non-invasive diagnostic tool to evaluate PC with prostate-specific membrane antigen (PSMA) expression, has emerged as a more accurate alternative to assess disease staging. We aimed to identify predictors of positive 68Ga-PSMA PET and the accuracy of this technique.

Materials and methods: Diagnostic accuracy cross-sectional study with prospective and retrospective approaches. We performed a comprehensive literature search on PubMed, Cochrane Library, and Embase database in search of studies including PC patients submitted to radical prostatectomy or radiotherapy with curative intent and presented biochemical recurrence following ASTRO 1996 criteria. A total of 35 studies involving 3910 patients submitted to 68-Ga-PSMA PET were included and independently assessed by two authors: 8 studies on diagnosis, four on staging, and 23 studies on restaging purposes. The significance level was α=0.05.

Results: pooled sensitivity and specificity were 0.90 (0.86-0.93) and 0.90 (0.82-0.96), respectively, for diagnostic purposes; as for staging, pooled sensitivity and specificity were 0.93 (0.86-0.98) and 0.96 (0.92-0.99), respectively. In the restaging scenario, pooled sensitivity and specificity were 0.76 (0.74-0.78) and 0.45 (0.27-0.58), respectively, considering the identification of prostate cancer in each described situation. We also obtained specificity and sensitivity results for PSA subdivisions.

Conclusion: 68Ga-PSMA PET provides higher sensitivity and specificity than traditional imaging for prostate cancer.

Keywords: (225)Ac-PSMA-617 [Supplementary Concept]; Glu-NH-CO-NH-Lys-(Ahx)-((68)Ga(HBED-CC)) [Supplementary Concept]; Prostate cancer, familial [Supplementary Concept].

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Summary of the study selection process.
Figure 2
Figure 2. Pooled sensibility and specificity in diagnosis scenario, considering only studies which included possible non-cancer cases (false positive).
Figure 3
Figure 3. A secondary analysis, when Budaus, L. Study was withdraw from the pool, the inconsistency became much lower, not changing, substantially, the sensitivity of the method.
Figure 4
Figure 4. Sensitivity and Specificity analysis in staging prostate cancer patients. Note in specificity analysis the high inconsistency among these studies.
Figure 5
Figure 5. Specificity analysis in staging prostate cancer patients, after secondary analysis that showed Herlermann, A. study was responsible for the great inconsistency. Recalling the study, the specificity was 0.99 (0.96 to 1.00) with no inconsistency between the studies.
Figure 6
Figure 6. ROC curve for 68Ga-PSMA-PET in diagnosis setting, showing an area under the curve of 0.9731.
Figure 7
Figure 7. 68Ga-PSMA-PET sensitivity for restating patients with biochemical recurrence of prostate cancer.
Figure 8
Figure 8. 68Ga-PSMA-PET specificity for restating patients with biochemical recurrence of prostate cancer.
Figure 9
Figure 9. SROC curve for the pooled sensitivities and specificities on restating scenario, showing an area under the curve of 0.73.
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References

    1. 1. Steele CB, Li J, Huang B, Weir HK. Prostate cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer. 2017; 123(Suppl 24):5160-77. - PMC - PubMed
    1. 2. [No authors]. National Cancer Institute Surveillance, Epidemiology, and ERP. Cancer Stat Facts: Prostate Cancer. NIH. [Internet]. Availlable at <https://seer.cancer.gov/statfacts/html/prost.html>.
    1. 3. Perera M, Papa N, Christidis D, Wetherell D, Hofman MS, Murphy DG, et al. Sensitivity, Specificity, and Predictors of Positive 68Ga-Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2016; 70:926-37. - PubMed
    1. 4. Umbehr MH, Müntener M, Hany T, Sulser T, Bachmann LM. The role of 11C-choline and 18F-fluorocholine positron emission tomography (PET) and PET/CT in prostate cancer: a systematic review and meta-analysis. Eur Urol. 2013; 64:106-17. - PubMed
    1. 5. Herrmann K, Bluemel C, Weineisen M, Schottelius M, Wester HJ, Czernin J, et al. Biodistribution and radiation dosimetry for a probe targeting prostate-specific membrane antigen for imaging and therapy. J Nucl Med. 2015; 56:855-61. - PMC - PubMed

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