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Review
. 2022 Nov 8;15(11):1368.
doi: 10.3390/ph15111368.

Can PSMA-Targeting Radiopharmaceuticals Be Useful for Detecting Hepatocellular Carcinoma Using Positron Emission Tomography? An Updated Systematic Review and Meta-Analysis

Alessio Rizzo  1 , Manuela Racca  1 , Domenico Albano  2 , Francesco Dondi  2 , Francesco Bertagna  2 , Salvatore Annunziata  3 , Giorgio Treglia  4   5   6
Affiliations
Review

Can PSMA-Targeting Radiopharmaceuticals Be Useful for Detecting Hepatocellular Carcinoma Using Positron Emission Tomography? An Updated Systematic Review and Meta-Analysis

Alessio Rizzo et al. Pharmaceuticals (Basel). .

Abstract

Background: Several studies proposed the use of positron emission tomography (PET) with Prostate-Specific Membrane Antigen (PSMA)-targeting radiopharmaceuticals in hepatocellular carcinoma (HCC). Our aim is to calculate the detection rate (DR) of this examination in HCC with a meta-analysis.

Methods: A comprehensive literature search of studies on the DR of PET/CT or PET/MRI with PSMA-targeting radiopharmaceuticals in HCC was performed. Original articles evaluating these imaging examinations both in newly diagnosed HCC patients and HCC patients with disease relapse were included. Pooled DR including 95% confidence intervals (95% CI) was calculated. Statistical heterogeneity was also assessed using the I2 test.

Results: The meta-analysis of six selected studies (126 patients) provided a DR of 85.9% for PET imaging with PSMA-targeting radiopharmaceuticals in the diagnosis of HCC. Moderate statistical heterogeneity among the included studies was found (I2 = 56%).

Conclusions: The quantitative data provided demonstrate the high DR of PET/CT or PET/MRI with PSMA-targeting radiopharmaceuticals for HCC lesion detection. However, more studies are needed to confirm the promising role of PSMA-targeted PET in HCC.

Keywords: PET; PSMA; hepatocellular carcinoma; imaging; liver; nuclear medicine; oncology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Summary of the study selection process for the systematic review and meta-analysis.
Figure 2
Figure 2
Summary of quality assessment according to QUADAS-2 tool. Studies included in the systematic review are classified as low risk or high risk of bias or applicability concerns for different domains (reported in the vertical axis). The horizontal axis indicates the percentage of studies. The graph suggests that more than 60% of the studies show a potentially high risk of bias in patient selection.
Figure 3
Figure 3
Meta-analysis on the detection rate of PET with PSMA-targeting radioligands in patients with hepatocellular carcinoma [28,29,30,31,32,33]. Blue lines indicate the 95% confidence interval values and blue squares indicate the detection rate value of each study. Trapezoid indicates the pooled value with 95% confidence interval values.
Figure 4
Figure 4
Funnel plot for publication bias assessment. The presence/absence of publication bias is judged taking into account the asymmetric/symmetric distribution of studies (red circles) in the funnel plot.
See this image and copyright information in PMC

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