Diagnostic Performance of Prostate-specific Membrane Antigen Positron Emission Tomography–targeted biopsy for Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis

Kawada, Tatsushi; Yanagisawa, Takafumi; Rajwa, Paweł; Motlagh, Reza Sari; Mostafaei, Hadi; Quhal, Fahad; Laukhtina, Ekaterina; Aydh, Abdulmajeed; König, Frederik; Pallauf, Maximilian; Pradère, Benjamin; Ceci, Francesco; Baltzer, Pascal; Hacker, Marcus; Rasul, Sazan; Karakiewicz, Pierre I.; Araki, Motoo; Nasu, Yasutomo; Shariat, Shahrokh F.

doi:10.1016/j.euo.2022.04.006

Cited by 42 publications

(29 citation statements)

References 36 publications

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“…These studies showed that integrated PET-MRI has superior diagnostic accuracy compared with mpMRI and is particularly useful in tumors with equivocal Prostate Imaging Reporting and Data System (PIRADS) classification of 3 [ 20 , 21 , 22 ]. Recently, we were able to confirm these results in a meta-analysis of five prospective studies with collectively 497 men and could highlight the favorable diagnostic precision of PSMA PET targeted biopsy to detect clinically significant PCa [ 23 ]. Furthermore, local characteristics of the tumor such as tumor infiltration into the seminal vesicle, as well as into the other neighbor organs like the urinary balder, rectum, and neurovascular bundle, can exactly be determined using combined PET-MR examination [ 7 ].…”

Section: Clinical Indications Of Psma Pet Examinations In Prostate Ca...mentioning

confidence: 56%

Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Rasul

Haug

2022

Cancers

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With the progressive aging of the population in industrially developed countries, as well as advances in diagnostic and biopsy techniques and improvements in patient awareness, the incidence of prostate cancer (PCa) is continuously increasing worldwide. Therefore, PCa is currently considered as the second leading cause of tumor-related death. Early detection of the tumor and its metastasis is essential, as the rate of disease recurrence is high and occurs in 27% to 53% of all patients who underwent curative therapy with radical prostatectomy or local radiotherapy. In this regard, the prostate specific membrane antigens, abbreviated as PSMAs, are type II membrane proteins that are highly expressed on the surface of malignant prostate tissue in PCa, particularly in aggressive, androgen-deprived, metastatic, and hormone-refractory PCa, and they are inversely associated with the androgen level. Up to 95% of adenocarcinomas of the prostate express PSMA receptors on their surface. Today, radionuclides that bind to these PSMA peptides are widely accepted for diagnostic and therapeutic purposes to specifically image and target prostate tumor cells at the molecular level, a process referred to as targeted theranostics. Numerous studies have demonstrated that the integration of these peptides into diagnostic and therapeutic procedures plays a critical role in the primary staging and treatment decisions of especially high-risk PCa, expands therapeutic options for patients with advanced stage of prostate tumor, and prolongs patients’ survival rate. In this review article, we intend to briefly spotlight the latest clinical utilization of the PSMA-targeted radioligand PET imaging modality in patients with different stages of PCa. Furthermore, limitations and pitfalls of this diagnostic technique are presented.

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Section: Clinical Indications Of Psma Pet Examinations In Prostate Ca...mentioning

confidence: 56%

Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Rasul

Haug

2022

Cancers

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“…Lopci et al [29] found that a maximum standardised uptake value of 5.4 and a maximum-to-background standardised uptake value ratio of 2 detect 100% of ISUP ≥2 tumours. In a recent meta-analysis, Kawada et al [30] demonstrate that PSMA-PET-TB appears to have favourable diagnostic accuracy for csPCa detection, achieving an NPV of 85%. Nevertheless, before broad implementation of PSMA-PET-TB in the diagnostic setting, standardisation and assessment of its cost effectiveness are required.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Role of High-resolution Microultrasound Among Naïve Patients with Negative Multiparametric Magnetic Resonance Imaging and a Persistently High Suspicion of Prostate Cancer

Avolio¹,

Lughezzani²,

Fasulo³

et al. 2023

European Urology Open Science

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“…14 A recent systematic review including five studies with a total of 459 patients showed a sensitivity of 91% and a negative predictive value of 81% for the combination of prebiopsy PSMA and MRI. 15 The standardized uptake value (SUV) of 68 Ga-PSMA-11 PET/CT was found to have a significant association with International Society of Urologic Pathology (ISUP) grade group (GG). [16][17][18] There are multiple PSMA tracers that have been shown to be able to detect clinically significant (cs) PCa lesions.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical and histopathological validation of ¹⁸F‐PSMA‐1007 PET/CT for intraprostatic cancerous lesions

et al. 2023

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IntroductionProstate‐specific membrane antigen (PSMA) is overexpressed in prostate cancer (PCa). In this study, we aim to immunohistochemically and histopathological validate the fluorine‐18 (18F)‐PSMA‐1007 positron emission tomography/computed tomography (PET/CT) for intraprostatic PCa lesions.MethodsBetween February 2019 and October 2020, patients with biopsy‐proven, treatment‐naïve intermediate‐to‐high‐risk PCa undergoing an 18F‐PSMA‐1007 PET/CT before robot‐assisted radical prostatectomy (RARP) were prospectively enrolled. For all PCa lesions found on whole‐mount histopathology, location, size, International Society of Urological Pathology (ISUP) grade group (GG), and immune reactive score (IRS) were assessed after PSMA staining. ISUP GG ≥ 3 PCa was defined as clinically significant (cs) PCa. All lesions were matched on PSMA PET/CT and the maximum standardized uptake value (SUVmax) was measured.ResultsA total of 125 lesions were analyzed in the 80 RARP specimens, of which 49 (40%) were csPCa and 76 (60%) non‐csPCa. Linear multivariable regressions showed that an increase in SUVmax significantly correlated with a higher ISUP GG (p values between 0.021 and 0.001) and a higher IRS (p = 0.017). Logistic multivariable regression showed that csPCa significantly correlated with a higher SUVmax (odds ratio, OR: 1.17 [95% confidence interval, CI: 1.04–1.21, p = 0.005]), an increase in tumor length (OR: 1.05 [95% CI 1.01–1.10, p = 0.020]) and a higher IRS (OR; 1.24 [95% CI 1.07–1.47, p = 0.006]). A SUVmax threshold of 4 would have resulted in one (2%) missed lesion with csPCa.ConclusionThis prospective study revealed that 18F‐PSMA‐1007 PET/CT SUVmax is correlated with the ISUP GG and IRS, and thereby could be a tool to characterize intraprostatic PCa lesions.

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Diagnostic Performance of Prostate-specific Membrane Antigen Positron Emission Tomography–targeted biopsy for Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis

Cited by 42 publications

References 36 publications

Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Assessing the Role of High-resolution Microultrasound Among Naïve Patients with Negative Multiparametric Magnetic Resonance Imaging and a Persistently High Suspicion of Prostate Cancer

Immunohistochemical and histopathological validation of ¹⁸F‐PSMA‐1007 PET/CT for intraprostatic cancerous lesions

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Diagnostic Performance of Prostate-specific Membrane Antigen Positron Emission Tomography–targeted biopsy for Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis

Cited by 42 publications

References 36 publications

Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Assessing the Role of High-resolution Microultrasound Among Naïve Patients with Negative Multiparametric Magnetic Resonance Imaging and a Persistently High Suspicion of Prostate Cancer

Immunohistochemical and histopathological validation of 18F‐PSMA‐1007 PET/CT for intraprostatic cancerous lesions

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Immunohistochemical and histopathological validation of ¹⁸F‐PSMA‐1007 PET/CT for intraprostatic cancerous lesions