scholarly journals The role of Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (PSMA PET/CT) in the selection of patients for salvage radiation therapy after radical prostatectomy

2021 ◽  
Vol 33 ◽  
pp. S256
Author(s):  
D. Meijer ◽  
R.M. Mohede ◽  
W.S.C. Eppinga ◽  
B.G.L. Vanneste ◽  
P. Meijnen ◽  
...  
Keyword(s):  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Salvage Radiation Therapy ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Specific Membrane ◽  
Selection Of Patients ◽  
Selection Of

scholarly journals Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of Prostate Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Sungmin Woo ◽  
Soleen Ghafoor ◽  
Anton S. Becker ◽  
Sangwon Han ◽  
Andreas Wibmer ◽  
...  
Keyword(s):  
Threshold Effect ◽  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Regression Analyses ◽  
Local Tumor ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Meta Regression ◽  
Specific Membrane

Abstract Purpose: Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has shown promise for detecting nodal and distant prostate cancer (PCa) metastases. However, its performance for local tumor staging is not as well established. The purpose of this study was to review the diagnostic performance of PSMA-PET for determining seminal vesical invasion (SVI) and extraprostatic extension (EPE).Methods: Pubmed and Embase databases were searched until January 12, 2020. Studies assessing accuracy of PSMA-PET in determining SVI and EPE were included. Study quality was evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity were calculated using hierarchical summary receiver operating characteristics modeling. Heterogeneity was explored using meta-regression analyses for anatomical imaging component (MRI vs CT) and by testing for a threshold effect.Results: 12 studies (615 patients) were included. Pooled sensitivity and specificity were 0.68 (95%CI 0.53-0.81) and 0.94 (95% CI 0.90-0.96) for SVI and 0.72 (95% CI 0.56-0.84) and 0.87 (95%CI 0.72-0.94) for EPE. Meta-regression analyses showed that for SVI, PET/MRI demonstrated greater sensitivity than PET/CT (0.87 [95%CI 0.75-0.98] vs 0.60 [95% CI 0.47-0.74]; p = 0.02 for joint model) while specificity was comparable (0.91 [95%CI 0.84-0.97] vs. 0.96 [95%CI 0.93-0.99]) but not for EPE (p = 0.08). A threshold effect was present for studies assessing EPE (correlation coefficient = 0.563 [95% CI, -0.234-0.908] between sensitivity and false-positive rate).Conclusion: PSMA-PET has moderate sensitivity and excellent specificity for assessing local tumor extent in patients with PCa. PET/MRI showed potential for greater sensitivity than PET/CT in assessing SVI.[S1] [S1]R1-1

scholarly journals Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of prostate cancer: a systematic review and meta-analysis

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Sungmin Woo ◽  
Soleen Ghafoor ◽  
Anton S. Becker ◽  
Sangwon Han ◽  
Andreas G. Wibmer ◽  
...  
Keyword(s):  
Threshold Effect ◽  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Regression Analyses ◽  
Local Tumor ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Meta Regression ◽  
Specific Membrane

Abstract Purpose Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has shown promise for detecting nodal and distant prostate cancer (PCa) metastases. However, its performance for local tumor staging is not as well established. The purpose of this study was to review the diagnostic performance of PSMA-PET for determining seminal vesical invasion (SVI) and extraprostatic extension (EPE). Methods Pubmed and Embase databases were searched until January 12, 2020. Studies assessing accuracy of PSMA-PET in determining SVI and EPE were included. Study quality was evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity were calculated using hierarchical summary receiver operating characteristics modeling. Heterogeneity was explored using meta-regression analyses for anatomical imaging component (MRI vs CT) and by testing for a threshold effect. Results Twelve studies (615 patients) were included. Pooled sensitivity and specificity were 0.68 (95% CI 0.53-0.81) and 0.94 (95% CI 0.90-0.96) for SVI and 0.72 (95% CI 0.56-0.84) and 0.87 (95% CI 0.72-0.94) for EPE. Meta-regression analyses showed that for SVI, PET/MRI demonstrated greater sensitivity than PET/CT (0.87 [95% CI 0.75-0.98] vs 0.60 [95% CI 0.47-0.74]; p = 0.02 for joint model) while specificity was comparable (0.91 [95% CI 0.84-0.97] vs. 0.96 [95% CI 0.93-0.99]) but not for EPE (p = 0.08). A threshold effect was present for studies assessing EPE (correlation coefficient = 0.563 [95% CI, −0.234-0.908] between sensitivity and false-positive rate). Conclusion PSMA-PET has moderate sensitivity and excellent specificity for assessing local tumor extent in patients with PCa. PET/MRI showed potential for greater sensitivity than PET/CT in assessing SVI.

scholarly journals Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of Prostate Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Sungmin Woo ◽  
Soleen Ghafoor ◽  
Anton S. Becker ◽  
Sangwon Han ◽  
Andreas Wibmer ◽  
...  
Keyword(s):  
Threshold Effect ◽  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Regression Analyses ◽  
Local Tumor ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Meta Regression ◽  
Specific Membrane

Abstract Purpose: Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has shown promise for detecting nodal and distant prostate cancer (PCa) metastases. However, its performance for local tumor staging is not as well established. The purpose of this study was to review the diagnostic performance of PSMA-PET for determining seminal vesical invasion (SVI) and extraprostatic extension (EPE).Methods: Pubmed and Embase databases were searched until January 12, 2020. Studies assessing accuracy of PSMA-PET in determining SVI and EPE were included. Study quality was evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity were calculated using hierarchical summary receiver operating characteristics modeling. Heterogeneity was explored using meta-regression analyses for anatomical imaging component (MRI vs CT) and by testing for a threshold effect.Results: 12 studies (615 patients) were included. Pooled sensitivity and specificity were 0.68 (95%CI 0.53-0.81) and 0.94 (95% CI 0.90-0.96) for SVI and 0.72 (95% CI 0.56-0.84) and 0.87 (95%CI 0.72-0.94) for EPE. Meta-regression analyses showed that for SVI, PET/MRI demonstrated greater sensitivity than PET/CT (0.87 [95%CI 0.75-0.98] vs 0.60 [95% CI 0.47-0.74]; p = 0.02 for joint model) while specificity was comparable (0.91 [95%CI 0.84-0.97] vs. 0.96 [95%CI 0.93-0.99]) but not for EPE (p = 0.08). A threshold effect was present for studies assessing EPE (correlation coefficient = 0.563 [95% CI, -0.234-0.908] between sensitivity and false-positive rate).Conclusion: PSMA-PET has moderate sensitivity and excellent specificity for assessing local tumor extent in patients with PCa. PET/MRI shows significantly greater sensitivity than PET/CT for assessing SVI.

scholarly journals Salvage lymph node dissection for prostate-specific membrane antigen (PSMA) positron emission tomography (PET)-identified oligometastatic disease

2021 ◽  
Vol 15 (10) ◽  
Author(s):  
Adam Bobrowski ◽  
Ur Metser ◽  
Antonio Finelli ◽  
Neil Fleshner ◽  
Alejandro Berlin ◽  
...  
Keyword(s):  
Salvage Surgery ◽  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Node Dissection ◽  
Oligometastatic Disease ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Prospective Trials ◽  
Specific Membrane

Introduction: The availability of prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) imaging, particularly in the setting of rising prostate-specific antigen (PSA) after definitive treatment, has led to oligometastatic prostate cancer being increasingly identified. Despite the enthusiasm surrounding treating oligometastatic disease, it has been relatively understudied. We sought to review our salvage lymphadenectomy experience in the PSMA PET/CT era. Methods: We retrospectively reviewed patients undergoing lymphadenectomy following curative intent primary therapy with rising PSA who had undergone a PSMA PET/CT identifying oligometastatic disease (defined as 5 PSMA-avid lesions) between January 2016 to April 2020. The primary endpoint was complete response, defined as achieving a PSA <0.2 ng/ml without concomitant androgen deprivation therapy (ADT). Results: Twenty-two patients were included. Primary curative therapy included radical prostatectomy (86.4%) and brachytherapy (13.6%). Median PSA at salvage surgery was 1.72 ng/ml. Pelvic lymph node dissection was the most performed procedure (72.7%). Median node yield was 10.5, with a median of 1.5 positive nodes on pathology. Eight patients (36.4%) achieved PSA <0.2, with six (27.3%) remaining with PSA <0.2 after a median followup of 23.1 months. Nine (40.9%) had an initial PSA decline, but nadired ≥0.2, and in five (22.7%) the PSA rose immediately after surgery. Overall, ADT was commenced in seven patients (31.8%) at a median of 10.1 months post-salvage surgery. Conclusions: In our series of salvage dissection for PSMA-PET-detected nodal oligometastases, approximately a third achieved PSA <0.2; yet, it was only durable in 27%. Prospective trials of salvage nodal radiation are ongoing; however, more prospective trials of salvage node dissection are needed.

scholarly journals 18F-PSMA-1007 PET in Biochemical Recurrent Prostate Cancer: An Updated Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Matteo Ferrari ◽  
Giorgio Treglia
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Targeted Agents ◽  
Recurrent Prostate Cancer ◽  
Positron Emission ◽  
Pet Ct ◽  
Specific Membrane

Background. Prostate-specific membrane antigen- (PSMA-) targeted agents labeled with fluorine-18 (18F) have recently become available to evaluate patients with biochemical recurrent prostate cancer (BRPCa) by using positron emission tomography/computed tomography (PET/CT) or positron emission tomography/magnetic resonance imaging (PET/MRI). We performed a systematic review and meta-analysis about the detection rate (DR) of 18F-PSMA-1007 PET/CT or PET/MRI in BRPCa patients. Methods. A comprehensive computer literature search of PubMed/MEDLINE, EMBASE, and Cochrane Library databases for studies published through 17 May 2021 was carried out using the following search algorithm: “PSMA” AND “1007”. Only studies providing data on the DR of 18F-PSMA-1007 PET/CT or PET/MRI in BRPCa were included. A random-effects model was used to calculate the pooled DR on a per scan basis. Results. Fifteen articles (853 patients) were selected and included in the systematic review, and ten were included in the quantitative analysis. Most of the studies reported a good DR of 18F-PSMA-1007 PET/CT or PET/MRI in BRPCa including also patients with low prostate-specific membrane antigen (PSA) values. The DR of 18F-PSMA-1007 PET/CT or PET/MRI was dependent on PSA serum values. The pooled DR was 81.3% (95% confidence interval: 74.6–88%) with statistical heterogeneity. A significant reporting bias (publication bias) was not detected. Conclusions. 18F-PSMA-1007 PET/CT or PET/MRI showed a good DR in BRPCa patients in line with other PSMA-targeted agents. The DR of 18F-PSMA-1007 PET/CT or PET/MRI is influenced by serum PSA values. These findings should be confirmed by prospective multicentric trials.

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