Diagnostic Performance of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging in Newly Diagnosed Intermediate to High-Risk Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Kim, Seong-Jang; Lee, Sang‐Woo; Ha, Hong Koo

doi:10.1159/000493169

Cited by 46 publications

(22 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Perera et al reported a sensitivity and specificity of 0.86 (95% CI, 0.37-0.98) and 0.86 (95% CI, 0.03-1.00), respectively, but merged data from both biochemical recurrence and initial staging patients (5). A second, more recent, metaanalysis performed only on the initial staging population closely mirrored our results, with estimated sensitivity and specificity of 0.71 (95% CI, 0.59-0.81) and 0.95 (95% CI, 0.87-0.99), respectively (15). von Eyben et al reported the sensitivity and specificity for initial staging alone-0.70 (95% CI, 0.53-0.83)-and pooled specificity was 0.84 (95% CI, 24-99) (4).…”

Section: Discussionsupporting

confidence: 70%

Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

et al. 2018

View full text Add to dashboard Cite

68 Ga-PSMA-11 PET is used to stage patients with prostate cancer. We performed an updated metaanalysis that separates imaging at the time of diagnosis and at the time of biochemical recurrence and focuses on pathology correlation in both populations. Methods: We searched the MEDLINE and EMBASE databases using the PRISMA statement. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool 2. In total, 1,811 studies were screened, 58 were analyzed, 41 were included for qualitative synthesis, and 29 were included for quantitative analysis. A random-effect model and a hierarchical summary receiver-operating-characteristic model were used to summarize the sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy for pelvic lymph nodes in initial staging compared with pathology at prostatectomy and the PPV for lesions with pathologic correlation in those with biochemical recurrence. We also summarized the detection rate of 68 Ga-PSMA-11 in those with biochemical recurrence stratified by prostate-specific antigen (PSA) at the time of imaging. Results: The metaanalysis of 68 Ga-PSMA-11 at initial staging demonstrated a sensitivity and specificity of 0.74 (95% confidence interval [95% CI], 0.51-0.89) and 0.96 (95% CI, 0.85-0.99), respectively, using nodal pathology at prostatectomy as a gold standard. At biochemical recurrence, the PPV was 0.99 (95% CI, 0.96-1.00). The detection rate was 0.63 (95% CI, 0.55-0.70), with a PSA of less than 2.0 and 0.94 (95% CI, 0.91-0.96) with a PSA of more than 2.0. Conclusion: 68 Ga-PSMA-11 performed well for the localization of metastatic prostate cancer at initial staging and at the time of biochemical recurrence.

show abstract

Section: Discussionsupporting

confidence: 70%

Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

et al. 2018

View full text Add to dashboard Cite

show abstract

“…PSMA PET has shown encouraging diagnostic properties in prostate cancer since the first clinical trial was published with Ga-68-PSMA-11 in 2012 [34]. Since then, the use of PSMA PET has been evaluated in numerous settings, including primary staging and biochemical recurrence, as shown in recent systematic reviews [8][9][10][11][12][13]. However, these recent systematic reviews only present a fraction of the knowledge of PSMA PET for primary lymph node staging.…”

Section: Discussionmentioning

confidence: 99%

“…A final search on August 16 also showed 123 references. The validity of the PubMed search string was verified by the identification of all references presented in the latest systematic reviews of 68Ga-PSMA PET/CT for primary staging with pathology as the reference [8][9][10][11]13]. All references were imported into EndNote X8 (Clarivate Analytics, Philadelphia, US) and were evaluated for inclusion in the review.…”

Section: Literature Searchmentioning

confidence: 99%

“…Also, some reports have shown encouraging data with PSMA PET/CT for the detection of lymph node metastases for primary staging. A notable number of systematic reviews have been published on this topic since 2018 [8][9][10][11][12][13]. These systematic reviews comprise a limited number (five to eight) original reports with primary staging with pathology as reference.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review

Petersen

Zacho

2020

Cancer Imaging

View full text Add to dashboard Cite

Background: PSMA PET is a promising method for primary lymph node staging in prostate cancer. However, recent systematic reviews have identified only a limited number of studies with histopathology as a reference test. Methods: A systematic search was performed in PubMed and the Cochrane Library. An expedited systematic review was performed where we identified diagnostic studies in prostate cancer where a preoperative PSMA PET for primary lymph node staging was compared to histopathology. The trials must have diagnostic data on a patient level. Results: Eighteen eligible clinical trials included 969 patients. The median patient number per study was 32 (range 10 to 208). Five trials were prospective, and nine trials had a consecutive enrolment of patients. Sixteen studies used Ga-68-PSMA-11; there was one study with Cu-64-PSMA and one study with F-18-DCDFPyL. Twelve studies used PET/CT, four trials used PET/MR. Most trials included patients with intermediate and high-risk. Diagnostic accuracy varied notably among the studies; sensitivity ranged from 23 to 100%, specificity 67-100%, positive predictive value 20-100%, and negative predictive value 41-100%. Weighted sensitivity was 59%, weighted specificity was 93%. Four studies compared PSMA PET with anatomical imaging (CT or MRI); in all cases, sensitivity and specificity were superior with PSMA PET. Three studies compared PSMA PET with multi-parametric or diffusion-weighted MRI with mixed results. Conclusions: PSMA PET showed promising diagnostic accuracy for primary lymph node staging with pathology as reference. Recommendation for PSMA PET for high-risk patients in clinical guidelines should be supported by confirmatory, prospective trials with patient-relevant outcomes.

show abstract

“…The specificity of CT was significantly lower the PSMA-PET (11). Recently, in a six-study meta-analysis, the overall sensitivity and specificity for PSMA-PET/CT was 71 and 95%, respectively (12). Hence, PSMA-PET is the most encouraging imaging modality for the detection of disease in LNs.…”

Section: Search For Metastases In Localized and Locally Advanced Prosmentioning

confidence: 96%

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

et al. 2020

View full text Add to dashboard Cite

Background: Initial staging and assessment of treatment activity in metastatic prostate cancer (PCa) patients is controversial. Indications for the various available imaging modalities are not well-established due to rapid advancements in imaging and treatment. Methods:We conducted a critical literature review of the main imaging abnormalities that suggest a diagnosis of metastasis in localized and locally advanced PCa or in cases of biological relapse. We also assessed the role of the various imaging modalities available in routine clinical practice for the detection of metastases and response to treatment in metastatic PCa patients. Results:In published clinical trials, the most commonly used imaging modalities for the detection and evaluation of therapeutic response are bone scan, abdominopelvic computed tomography (CT), and pelvic and bone magnetic resonance imaging (MRI). For the detection and follow-up of metastases during treatment, modern imaging techniques i.e., choline-positron emission tomography (PET), fluciclovine-PET, or Prostate-specific membrane antigen (PSMA)-PET provide better sensitivity and specificity. This is particularly the case of fluciclovine-PET and PSMA-PET in cases of biochemical recurrence with low values of prostate specific antigen. Conclusions:In routine clinical practice, conventional imaging still have a role, and communication between imagers and clinicians should be encouraged. Present and future clinical trials should use modern imaging methods to clarify their usage. Inclusion and Exclusion CriteriaOnly original manuscripts and reviews published in indexed and peer-reviewed journals and written in English between August 1999 and December 2019 were considered. Cross-sectional studies, case reports, published abstracts, dissertation materials, and conference presentations were excluded. Of 1,725 potential articles from the literature search, 105 were selected, including 16 literature reviews, 5 meta-analyses, 11 guidelines or position papers, and 73 original articles.

show abstract

Diagnostic Performance of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging in Newly Diagnosed Intermediate to High-Risk Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Cited by 46 publications

References 35 publications

Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

Contact Info

Product

Resources

About

Diagnostic Performance of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging in Newly Diagnosed Intermediate to High-Risk Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Cited by 46 publications

References 35 publications

Metaanalysis of 68Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

Metaanalysis of 68Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review

Imaging for Metastasis in Prostate Cancer: A Review of the Literature

Contact Info

Product

Resources

About

Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology

Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for the Detection of Prostate Cancer Validated by Histopathology