The Role of Laparoscopy in Prostate Cancer Staging

Objective: To evaluate the usage of MRI in prostate cancer staging, especially in nodal involvement (N-staging) and metastasis (M-staging) of prostate cancer. Methods: This is a systematic review and meta-analysis assessing role of MRI in nodal and metastasis staging of prostate cancer. Search of studies were done through search engine using Pubmed, Cochrane, and EBSCO Host and manual searching. Quality of eligible studies were assessed using a revised version of Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and analyzed in pooled analysis according to nodal involvement or metastasis staging, modality of diagnosis used as the index test and gold standard used using STATA version 13. Results: Total 26 studies corresponding with study’s eligibility criteria were found. Overall, usage of MRI has a sensitivity of 47% (95% CI 35% - 60%; I2 83.08%) and a specificity of 93% (95% CI 89% - 96%, I2 82.21%) in nodal involvement staging of prostate cancer, while using of MRI in M-staging of prostate cancer shows a sensitivity of 94% (95% CI 86% - 97%) and a specificity of 99% (95% CI 97% - 99%). Using lymphotrophic superparamagnetic nanoparticle (LSN) - enhanced MRI gives higher sensitivity than using MRI without LSN for N-staging of prostate cancer. Conclusion: The usage of MRI in prostate cancer staging has a moderate sensitivity and relatively high specificity in detecting lymph node. Moreover, it plays an important role and even can be used as a modality of choice in assisting bone metastatic prostate cancer detection.

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Diagnostic Role of 18F-PSMA-1007 PET/CT in Prostate Cancer Staging: A Systematic Review

Diagnostics ◽

10.3390/diagnostics11030552 ◽

2021 ◽

Vol 11 (3) ◽

pp. 552

Author(s):

Salam Awenat ◽

Arnoldo Piccardo ◽

Patricia Carvoeiras ◽

Giovanni Signore ◽

Luca Giovanella ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Diagnostic Accuracy ◽

Metastatic Disease ◽

Cancer Staging ◽

Relevant Information ◽

Cochrane Library ◽

Number Of Patients ◽

Pet Ct

Background: The use of prostate-specific membrane antigen (PSMA)-targeted agents for staging prostate cancer (PCa) patients using positron emission tomography/computed tomography (PET/CT) is increasing worldwide. We performed a systematic review on the role of 18F-PSMA-1007 PET/CT in PCa staging to provide evidence-based data in this setting. Methods: A comprehensive computer literature search of PubMed/MEDLINE and Cochrane Library databases for studies using 18F-PSMA-1007 PET/CT in PCa staging was performed until 31 December 2020. Eligible articles were selected and relevant information was extracted from the original articles by two authors independently. Results: Eight articles (369 patients) evaluating the role of 18F-PSMA-1007 PET/CT in PCa staging were selected. These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of 18F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Overall, higher primary PCa aggressiveness was associated with higher 18F-PSMA-1007 uptake. When compared with other radiological and scintigraphic imaging methods, 18F-PSMA-1007 PET/CT had superior sensitivity in detecting metastatic disease and the highest inter-reader agreement. 18F-PSMA-1007 PET/CT showed similar results in terms of diagnostic accuracy for PCa staging compared with PET/CT with other PSMA-targeted tracers. Dual imaging with multi-parametric magnetic resonance imaging and 18F-PSMA-1007 PET/CT may improve staging of primary PCa. Notably, 18F-PSMA-1007-PET/CT may detect metastatic disease in a significant number of patients with negative standard imaging. Conclusions: 18F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging. Prospective multicentric studies are needed to confirm these findings.

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