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

Giorgio Treglia; Salvatore Annunziata; Daniele A Pizzuto; Luca Giovanella; John O Prior; Luca Ceriani

doi:10.3390/cancers11050710

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

Cancers (Basel). 2019 May 23;11(5):710. doi: 10.3390/cancers11050710.

Authors

Giorgio Treglia^{1

2

3}, Salvatore Annunziata⁴, Daniele A Pizzuto⁵, Luca Giovanella^{6

7}, John O Prior⁸, Luca Ceriani^{9

10}

Affiliations

¹ Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland. [email protected].
² Health Technology Assessment Unit, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland. [email protected].
³ Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, CH-1011 Lausanne, Switzerland. [email protected].
⁴ Nuclear Medicine Unit, IFO Regina Elena National Cancer Institute, IT-00144 Rome, Italy. [email protected].
⁵ Department of Nuclear Medicine, University Hospital of Zürich, CH-8091 Zürich, Switzerland. [email protected].
⁶ Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland. [email protected].
⁷ Department of Nuclear Medicine, University Hospital of Zürich, CH-8091 Zürich, Switzerland. [email protected].
⁸ Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, CH-1011 Lausanne, Switzerland. [email protected].
⁹ Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland. [email protected].
¹⁰ Department of Nuclear Medicine, University Hospital of Zürich, CH-8091 Zürich, Switzerland. [email protected].

Abstract

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.

Keywords: DCFBC; DCFPyL; PET; PSMA; PSMA-1007; prostate.

Publication types

Review