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Abstract

Volume 24, Issue 4 (July 2022) 24, 373–379; 10.4103/aja202162

The performance of 18F-PSMA PET/CT in the detection of prostate cancer: a systematic review and meta-analysis

Zhi-Qiang Qin1, Gao-Jian Pan1,2,3, Zheng Xu1, Hao Wang1, Lu-Wei Xu1, Rui-Peng Jia1

1 Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
2 Department of Urology, Yancheng Third People's Hospital, Yancheng 224000, China
3 Department of Urology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng 224000, China

Correspondence: Dr. RP Jia (ruipengj@163.com)

Date of Submission 03-Apr-2021 Date of Acceptance 02-Aug-2021 Date of Web Publication 29-Oct-2021

Abstract

This paper presents a meta-analysis regarding the detection rate (DR) of fluorine-18 (18F)-labeled prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in the management of patients with prostate cancer (PCa). Relevant studies regarding 18F-PSMA PET/CT in the management of PCa published until June 1, 2021, were electronically searched in online databases including EMBASE, PubMed, and Web of Science. The primary outcome was the DR of 18F-PSMA PET/CT in managing PCa patients, while the secondary outcome was the DR of 18F-PSMA PET/CT according to Gleason scores and serum prostate-specific antigen (PSA) level. The pooled DR was calculated on a per-patient basis, with pooled odd ratios and 95% confidence intervals (CIs). In total, 17 observational studies evaluating 1019 patients with PCa met the inclusion criteria. The DR of 18F-PSMA PET/CT was 0.83 (95% CI: 0.78–0.88), in the random-effects model. Subsequently, the analysis of DR of 18F-PSMA PET/CT in PCa patients using Gleason score (≤7 vs ≥8), showed a significant difference in PCa patients. Based on the above results, the higher Gleason score of PCa patients, the higher DR of 18F-PSMA PET/CT. The DR of 18F-PSMA PET/CT in PCa was 0.57 for PSA <0.5 ng ml−1; 0.75 for PSA ≥0.5 ng ml-1 and <1.0 ng ml-1; 0.93 for PSA ≥1.0 ng ml-1 and <2.0 ng ml-1; and 0.95 for PSA ≥2.0 ng ml−1. Therefore, the significant diagnostic value was found in terms of the DR of 18F-PSMA PET/CT in managing PCa patients and was associated with Gleason score and serum PSA level.

Keywords: 18F-PSMA PET/CT; detection rate; meta-analysis; prostate cancer

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