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

Abstract

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.

Recurrent Prostate Cancer Diagnostics with 18F-PSMA-1007 PET/CT: A Systematic Review of the Current State

“…It has been reported that the detection rate (DR) of 18 F-PSMA-1007 PET/CT in local recurrence is related to PSA serum values. Results of the meta-analysis by Ferrari et al confirmed that 18 F-PSMA-1007 PET/CT demonstrated a good detection rate in biochemical recurrent prostate cancer (81.3%) and higher PSA values were associated with higher DR [ 38 ]. In addition, in a study by Lengana et al, the detection rate depending on the PSA level was determined.…”

Biokinetics and dosimetry of 18F‐PSMA‐1007 in patients with prostate cancer

“…The main advantage of 18 F‐PSMA‐1007 is the possibility of large‐scale production in a cyclotron. Low excretion in urine compared to 68 Ga‐PSMA is theoretically advantageous but clinical superiority has not been established, possibly due to a higher number of unspecific findings (primarily in bone) (Awenat et al, 2021 ; Fendler et al, 2017 ; Ferrari & Treglia, 2021 ).…”

PSMA-1007 Uptake in Ganglia of the Sympathetic Trunk and Its Intra-individual Reproducibility

“…Its rapid blood clearance and high tumor-to-background ratios provide a high sensitivity and allow the detection of the smallest tumor lesions even in patients with low serum PSA levels. Furthermore, due to reduced urinary excretion of [ 18 F]PSMA-1007, local recurrence of PCa or regional lymph node metastases can be more accurately detected [ 3 , 4 , 21 – 24 ]. But also, benign findings are detected more often.…”

“…But also, benign findings are detected more often. Especially unspecific uptake in ganglia, in the ribs, or in unspecific lymph nodes should not be misinterpreted as metastases [ 8 , 21 ]. [ 18 F]PSMA-1007 can have a higher rate of tracer uptake in ganglia compared to [ 68 Ga]Ga-PSMA-11 [ 14 ].…”