Correlation between PSA kinetics and detection rate of PSMA-PET in the setting of biochemical recurrent prostate cancer: A systematic review and meta-analysis.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 71-71
Author(s):  
Ricardo Pereira Mestre ◽  
Giorgio Treglia ◽  
Matteo Ferrari ◽  
Mariarosa Pascale ◽  
Calogero Mazzara ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Detection Rate ◽  
Meta Analysis ◽  
Specific Antigen ◽  
Cochrane Library ◽  
Recurrent Prostate Cancer ◽  
Psa Kinetics ◽  
Psma Pet ◽  
Statistical Heterogeneity

71 Background: Serum prostate-specific antigen (PSA) may predict the risk of positive positron emission tomography/computed tomography with radiolabeled prostate-specific membrane antigen (PSMA-PET/CT) in patients with biochemical recurrent prostate cancer (BRPCa). However, to date, there are no clear data regarding the correlation between PSA kinetics and PSMA-PET findings. We performed a systematic review and meta-analysis to provide evidence-based data in this setting. Methods: A comprehensive literature search of studies published through October 2018 in PubMed/MEDLINE, EMBASE and Cochrane library databases was performed. A meta-analysis to establish the detection rate (DR) of PSMA-PET using different cut-off values of PSA doubling time (PSAdt) and a pooled analysis to establish whether shorter PSAdt may predict positive PSMA-PET results was performed in patients with BRPCa. Results: Twelve articles were included in the systematic review and eight articles (including 1398 patients) were selected for the meta-analysis. The pooled DR including 95% confidence intervals (95% CI) of PSMA-PET in restaging prostate cancer (PCa) patients was 72% (95% CI: 60-82%), increasing to 83% (95% CI: 75-90%) when PSAdt was ≤ 6 months and decreasing to 60% (95% CI: 37-80%) when PSAdt was > 6 months. PSAdt ≤ 6 months may predict the positive result of PSMA-PET (pooled odds ratio: 3.22; 95% CI: 1.17-8.88). Statistical heterogeneity among the included studies was found. Conclusions: PSA kinetics, and in particular shorter PSAdt, may be predictor of PSMA-PET positivity in patients with BRPCa. Further larger studies in this setting are warranted.

scholarly journals Detection Rate of 18F-Labeled PSMA PET/CT in Biochemical Recurrent Prostate Cancer: A Systematic Review and a Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 710 ◽  
Author(s):  
Giorgio Treglia ◽  
Salvatore Annunziata ◽  
Daniele A. Pizzuto ◽  
Luca Giovanella ◽  
John O. Prior ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Detection Rate ◽  
Meta Analysis ◽  
Specific Antigen ◽  
Cochrane Library ◽  
Recurrent Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Statistical Heterogeneity

Background: The use of radiolabeled prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for biochemical recurrent prostate cancer (BRPCa) is increasing worldwide. Recently, 18F-labeled PSMA agents have become available. We performed a systematic review and meta-analysis regarding the detection rate (DR) of 18F-labeled PSMA PET/CT in BRPCa to provide evidence-based data in this setting. Methods: A comprehensive literature search of PubMed/MEDLINE, EMBASE, and Cochrane Library databases through 23 April 2019 was performed. Pooled DR was calculated on a per-patient basis, with pooled proportion and 95% confidence interval (95% CI). Furthermore, pooled DR of 18F-PSMA PET/CT using different cut-off values of prostate-specific antigen (PSA) was obtained. Results: Six articles (645 patients) were included in the meta-analysis. The pooled DR of 18F-labeled PSMA PET/CT in BRPCa was 81% (95% CI: 71–88%). The pooled DR was 86% for PSA ≥ 0.5 ng/mL (95% CI: 78–93%) and 49% for PSA < 0.5 ng/mL (95% CI: 23–74%). Statistical heterogeneity was found. Conclusions: 18F-labeled PSMA PET/CT demonstrated a good DR in BRPCa. DR of 18F-labeled PSMA PET/CT is related to PSA values with significant lower DR in patients with PSA < 0.5 ng/mL. Prospective multicentric trials are needed to confirm these findings.

scholarly journals Performance of 18F-DCFPyL PET/CT Imaging in Early Detection of Biochemically Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiale Sun ◽  
Yuxin Lin ◽  
Xuedong Wei ◽  
Jun Ouyang ◽  
Yuhua Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Early Detection ◽  
Publication Bias ◽  
Detection Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Recurrent Prostate Cancer ◽  
Pet Ct ◽  
Statistical Heterogeneity

Background: Prostate-specific membrane antigen (PSMA)-targeted 2-(3-{1-carboxy-5-[(6-[18F] fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) positron emission tomography/computed tomography (PET/CT) has shown advantages in primary staging, restaging, and metastasis detection of prostate cancer (PCa). However, little is known about the role of 18F-DCFPyL PET/CT in biochemically recurrent prostate cancer (BRPCa). Hence, we performed a systematic review and meta-analysis to evaluate 18F-DCFPyL PET/CT as first-line imaging modality in early detection of BRPCa.Methods: A comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane Library was conducted until December 2020. The pooled detection rate on a per-person basis and together with 95% confidence interval (CI) was calculated. Furthermore, a prostate-specific antigen (PSA)-stratified performance of detection positivity was obtained to assess the sensitivity of 18F-DCFPyL PET/CT in BRPCa with different PSA levels.Results: A total of nine eligible studies (844 patients) were included in this meta-analysis. The pooled detection rate (DR) of 18F-DCFPyL PET/CT in BRPCa was 81% (95% CI: 76.9–85.1%). The pooled DR was 88.8% for PSA ≥ 0.5 ng/ml (95% CI: 86.2–91.3%) and 47.2% for PSA &lt; 0.5 ng/ml (95% CI: 32.6–61.8%). We also noticed that the regional lymph node was the most common site with local recurrence compared with other sites (45.8%, 95% CI: 42.1–49.6%). Statistical heterogeneity and publication bias were found.Conclusion: The results suggest that 18F-DCFPyL PET/CT has a relatively high detection rate in BRPCa. The results also indicate that imaging with 18F-DCFPyL may exhibit improved sensitivity in BRPCa with increased PSA levels. Considering the publication bias, further large-scale multicenter studies are warranted for validation.

scholarly journals Comparison of 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT in patients with prostate cancer: a protocol for systematic review and meta-analysis

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Garba Haruna Yunusa ◽  
Aminu Umar Kaoje ◽  
Akintunde Taiwo Orunmuyi ◽  
Stuart S. More ◽  
Zabah Muhammad Jawa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Service Providers ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Suitable Alternative ◽  
Psma Pet ◽  
Pet Ct ◽  
Statistical Heterogeneity ◽  
Wide Range

Abstract Background A wide range of nuclear imaging probes have been developed to address different metabolic processes and cell receptors in prostate cancer patients using positron emission techniques to aid diagnosis, staging, and monitoring for recurrence after treatment. While 68Ga PSMA is a generator-derived PET radiopharmaceutical, SPECT/CT imaging using technetium-99m-labeled PSMA is now available as a suitable alternative. The aim of this study is to compare the pooled sensitivity, specificity, and accuracy of 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT in patients with prostate cancer. Main body of the abstract A search strategy was developed using text words, MeSH, and entry terms. The following databases will be searched: PubMed, African Journals Online (AJOL), Embase, Google scholar, ResearchGate, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Eligibility criteria include (a) all studies that are published or retrievable in English language, (b) observational studies, and (c) histopathology analysis or clinical and imaging follow-up or comparison with reference standards. Exclusion criteria will be interventional studies, editorials, reviews, and commentaries. Quality of the studies will be assessed using QUADAS2 Quality scores and risk of bias for individual studies will be reported. Full text of the studies will be reviewed and snowballed for any relevant literature. Assessment of methodological, clinical, and statistical heterogeneity for all the included studies will be made. Publication bias will be assessed using funnel plots. Statistical analysis and forest plots will be performed using the Open Meta-analyst software. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement. Short conclusion This review will provide data on diagnostic accuracy of 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT in patients with prostate cancer. Results from this study will help nuclear medicine service providers to make better decisions on the appropriate use of 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT especially with regard to the use of 99mTc-PSMA SPECT/CT which is relatively affordable and more readily available in developing countries when compared to 68-Ga PSMA PECT/CT.

scholarly journals Comparing the diagnostic performance of radiotracers in recurrent prostate cancer: a systematic review and network meta-analysis

2021 ◽  
Author(s):  
Ian Leigh Alberts ◽  
Svenja Elizabeth Seide ◽  
Clemens Mingels ◽  
Karl Peter Bohn ◽  
Kuangyu Shi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Publication Bias ◽  
Detection Rate ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Unmet Need ◽  
Current Evidence ◽  
Matched Pair ◽  
Recurrent Prostate Cancer

Abstract Purpose Many radiotracers are currently available for the detection of recurrent prostate cancer (rPC), yet many have not been compared head-to-head in comparative imaging studies. There is therefore an unmet need for evidence synthesis to guide evidence-based decisions in the selection of radiotracers. The objective of this study was therefore to assess the detection rate of various radiotracers for the rPC. Methods The PUBMED, EMBASE, and the EU and NIH trials databases were searched without date or language restriction for comparative imaging tracers for 13 radiotracers of principal interest. Key search terms included 18F-PSMA-1007, 18F-DCPFyl, 68Ga-PSMA-11, 18F-PSMA-11, 68Ga-PSMA-I&T, 68Ga-THP-PSMA, 64Cu-PSMA-617, 18F-JK-PSMA-7, 18F-Fluciclovine, 18F-FABC, 18F-Choline, 11C-Choline, and 68Ga-RM2. Studies reporting comparative imaging data in humans in rPC were selected. Single armed studies and matched pair analyses were excluded. Twelve studies with eight radiotracers were eligible for inclusion. Two independent reviewers screened all studies (using the PRISMA-NMA statement) for inclusion criteria, extracted data, and assessed risk of bias (using the QUADAS-2 tool). A network meta-analysis was performed using Markov-Chain Monte Carlo Bayesian analysis to obtain estimated detection rate odds ratios for each tracer combination. Results A majority of studies were judged to be at risk of publication bias. With the exception of 18F-PSMA-1007, little difference in terms of detection rate was revealed between the three most commonly used PSMA-radiotracers (68Ga-PSMA-11, 18F-PSMA-1007, 18F-DCFPyl), which in turn showed clear superiority to choline and fluciclovine using the derived network. Conclusion Differences in patient-level detection rates were observed between PSMA- and choline-radiotracers. However, there is currently insufficient evidence to favour one of the four routinely used PSMA-radioligands (PSMA-11, PSMA-1007, PSMA-I&T, and DCFPyl) over another owing to the limited evidence base and risk of publication bias revealed by our systematic review. A further limitation was lack of reporting on diagnostic accuracy, which might favour radiotracers with low specificity in an analysis restricted only to detection rate. The NMA derived can be used to inform the design of future clinical trials and highlight areas where current evidence is weak.

Clinical utility of PSMA PET in biochemically recurrent prostate cancer: A systematic review and meta-analysis

2019 ◽  
Vol 18 (11) ◽  
pp. e3497
Author(s):  
M. Perera ◽  
N. Papa ◽  
M. Roberts ◽  
C. Udovicic ◽  
I. Vela ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Clinical Utility ◽  
Meta Analysis ◽  
Recurrent Prostate Cancer ◽  
Psma Pet

scholarly journals PSA and PSA Kinetics Thresholds for the Presence of 68Ga-PSMA-11 PET/CT-Detectable Lesions in Patients with Biochemical Recurrent Prostate Cancer

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 398 ◽  
Author(s):  
Manuela Andrea Hoffmann ◽  
Hans-Georg Buchholz ◽  
Helmut J. Wieler ◽  
Matthias Miederer ◽  
Florian Rosar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Characteristic Curve ◽  
Specific Antigen ◽  
Recurrent Prostate Cancer ◽  
Psa Kinetics ◽  
Scan Time ◽  
Positron Emission ◽  
Pet Ct ◽  
Positive Scan ◽  
Previously Treated

68Ga-PSMA-11 positron-emission tomography/computed tomography (PET/CT) is commonly used for restaging recurrent prostate cancer (PC) in European clinical practice. The goal of this study is to determine the optimum time for performing these PET/CT scans in a large cohort of patients by identifying the prostate-specific-antigen (PSA) and PSA kinetics thresholds for detecting and localizing recurrent PC. This retrospective analysis includes 581 patients with biochemical recurrence (BC) by definition. The performance of 68Ga-PSMA-11 PET/CT in relation to the PSA value at the scan time as well as PSA kinetics was assessed by the receiver-operating-characteristic-curve (ROC) generated by plotting sensitivity versus 1-specificity. Malignant prostatic lesions were identified in 77%. For patients that were treated with radical prostatectomy (RP) a PSA value of 1.24 ng/mL was found to be the optimal cutoff level for predicting positive and negative scans, while for patients previously treated with radiotherapy (RT) it was 5.75 ng/mL. In RP-patients with PSA value <1.24 ng/mL, 52% scans were positive, whereas patients with PSA ≥1.24 ng/mL had positive scan results in 87%. RT-patients with PSA <5.75 ng/mL had positive scans in 86% and for those with PSA ≥5.75 ng/mL 94% had positive scans. This study identifies the PSA and PSA kinetics threshold levels for the presence of 68Ga-PSMA-11 PET/CT-detectable PC-lesions in BC patients.

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