Performance of 18F-DCFPyL PET/CT Imaging in Early Detection of Biochemically Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis

Sun, Jiale; Lin, Yuxin; Wei, Xuedong; Ouyang, Jun; Huang, Yuhua; Ling, Zhixin

doi:10.3389/fonc.2021.649171

Cited by 18 publications

(21 citation statements)

References 56 publications

(67 reference statements)

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“…Whereas other meta-analyses have investigated the diagnostic roles of tracers applied in PCa with BCR [ 2 , 6 , 7 , 78 , 79 ], to our knowledge, this is the first comparative meta-analysis that focuses on all three relevant tracers for the early detection of this disease. This meta-analysis showed a higher pooled DR for PCa with BCR using PSMA compared to that with fluciclovine and choline PET/CT for three PSA levels, and we observed a significant difference.…”

Section: Discussionmentioning

confidence: 99%

“…To date, to our knowledge, this is the first evidence-based study to evaluate the DRs of 18 F-labeled and 68 Ga-labeled PSMA. Recently, there have been multiple meta-analyses showing that the summary DR of 18 F-labeled PSMA in patients with BCR was approximately 49% for PSA < 0.5 ng/mL [ 1 , 78 , 85 ], which is slightly better than the 44.9% detection rate of 68 Ga-PSMA in a recent prospective study [ 73 ]. Compared to 18 F-PSMA, 68 Ga-PSMA ligands have a short half-life (68 min), and thus are inconvenient for transport [ 86 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparing the diagnostic performance of radiotracers in prostate cancer biochemical recurrence: a systematic review and meta-analysis

Mao

Yang

et al. 2022

Eur Radiol

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Objectives To systematically assess the early detection rate of biochemical prostate cancer recurrence using choline, fluciclovine, and PSMA. Methods Under the guidance of the Preferred Reporting Items for Systematic reviews and Meta-Analysis Diagnostic Test Accuracy guidelines, literature that assessed the detection rates (DRs) of choline, fluciclovine, and PSMA in prostate cancer biochemical recurrence was searched in PubMed and EMBASE databases for our systematic review from 2012 to July 15, 2021. In addition, the PSA-stratified performance of detection positivity was obtained to assess the DRs for various methods, including fluciclovine, PSMA, or choline PET/CT, with respect to biochemical recurrence based on different PSA levels. Results In total, 64 studies involving 11,173 patients met the inclusion criteria. Of the studies, 12, 7, and 48 focused on choline, fluciclovine, and PSMA, respectively. The pooled DRs were 24%, 37%, and 44%, respectively, for a PSA level less than 0.5 ng/mL (p < 0.001); 36%, 44%, and 60% for a PSA level of 0.5–0.99 ng/mL (p < 0.001); and 50%, 61%, and 80% for a PSA level of 1.0–1.99 ng/mL (p < 0.001). The DR with 18F-labeled PSMA was higher than that with 68Ga-labeled PSMA, and the DR was 58%, 72%, and 88% for PSA levels < 0.5 ng/mL, 0.5–0.9 ng/mL, and 1.0–1.99 ng/mL, respectively. Conclusion The DRs of PSMA-radiotracers were greater than those of choline-radiotracers and fluciclovine-radiotracers at the patient level. 18F-labeled PSMA achieved a higher DR than 68Ga-labeled PSMA. Key Points • The DRs of PSMA-radiotracers were greater than those of choline-radiotracers and fluciclovine-radiotracers at the patient level. •18F-labeled PSMA achieved a higher DR than68Ga-labeled PSMA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing the diagnostic performance of radiotracers in prostate cancer biochemical recurrence: a systematic review and meta-analysis

Mao

Yang

et al. 2022

Eur Radiol

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“…Another study comparing piflufolastat 18 F to a 68 Ga labeled PSMA compound revealed better sensitivity with an 18F-labeled compound [22]. A meta-analysis on piflufolastat 18 F accuracy in prostate cancer BCR revealed similar detection rates to this study’s analog PET/CT cohort [23].…”

Section: Discussionmentioning

confidence: 55%

Comparing digital to analog prostate-specific membrane antigen-targeted piflufolastat 18F PET/CT in prostate cancer patients in early biochemical failure

Maliha

Nolet

Ebrahim

et al. 2022

Nuclear Medicine Communications

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Purpose Prostate-specific membrane antigen (PSMA) positron emission tomography/computer tomography (PET/CT) in prostate cancer patients with biochemical failure(BCF) showslimited sensitivity when the prostate-specific antigen(PSA) <0.5 ng/mL. The development of digital PET/CT has greatly improved smaller lesion detection. This study's goal was to compare the performance and clinical value of PSMAtargeted piflufolastat PET/CT for prostate cancer BCF with digital versus analog PET/CT. MethodsIn this retrospective study, all piflufolastat PET/CT scans in subjects with PSA ≤ 3.0 ng/mL who were referred for prostate cancer BCF were included. The performance characteristics of 171 analog PET/ CT studies in 155 subjects from May 2017 to January 2020 and 106 digital PET/CT studies in 103 subjects from February 2020 to December 2020 were compared. Lesions were considered malignant if they did not match the known physiological distribution of piflufolastat and did not represent uptake in benign lesions. PSMA PET/CT studies were considered positive if at least one malignant lesion was detected and negative if none were detected. ResultsDigital piflufolastat PET/CT outperformed analog piflufolastat PET/CT in subjects with PSA < 0.5 ng/ mL with a positivity rate of 69% versus 37%, respectively. In patients with PSA ≥ 0.5 ng/mL, both technologies performed similarly. There was no statistically significant difference between the number or size of piflufolastat-avid lesions detected per PET/CT study. ConclusionIn prostate cancer patients with BCF and PSA < 0.5 ng/mL, digital piflufolastat PET/CT has a higher detection rate of malignant lesions than analog piflufolastat PET/CT.

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“…In a performance evaluation of [ 18 F]DCFPyL PET/CT, in patients with recurrent PCa and low PSA levels, the detection rates were 63.6% (<0.2 ng/mL), 58.7% (0.2–0.49 ng/mL), 62.8% (0.5–0.99 ng/mL), 82.1% (1–1.99 ng/mL), and 91.7% (>2 ng/mL) [ 5 ], which were higher than for primary staging [ 90 ]. Recently, a meta-analysis reviewing the diagnostic performance of [ 18 F]DCFPyL in the early detection of BCR showed a pooled detection rate of 81% [ 93 ]. The author further stratified the detection rate by PSA values; the pooled detection rate was 88.8% for PSA values > 0.5 ng/mL and 47.2% for the PSA value < 0.5 ng/mL.…”

Section: Resultsmentioning

confidence: 99%

The Performance of FDA-Approved PET Imaging Agents in the Detection of Prostate Cancer

Zelchan

Orlova

2022

Biomedicines

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Positron emission tomography (PET) incorporated with X-ray computed tomography (PET/CT) or magnetic resonance imaging (PET/MRI) is increasingly being used as a diagnostic tool for prostate cancer (PCa). In this review, we describe and evaluate the clinical performance of some Food and Drug Administration (FDA)-approved agents used for visualizing PCa: [18F]FDG, [11C]choline, [18F]FACBC, [68Ga]Ga-PSMA-11, [18F]DCFPyL, and [18F]-NaF. We carried out a comprehensive literature search based on articles published from 1 January 2010 to 1 March 2022. We selected English language articles associated with the discovery, preclinical study, clinical study, and diagnostic performance of the imaging agents for the evaluation. Prostate-specific membrane antigen (PSMA)-targeted imaging agents demonstrated superior diagnostic performance in both primary and recurrent PCa, compared with [11C]choline and [18F]FACBC, both of which target dividing cells and are used especially in patients with low prostate-specific antigen (PSA) values. When compared to [18F]-NaF (which is suitable for the detection of bone metastases), PSMA-targeted agents were also capable of detecting lesions in the lymph nodes, soft tissues, and bone. However, a limitation of PSMA-targeted imaging was the heterogeneity of PSMA expression in PCa, and consequently, a combination of two PET tracers was proposed to overcome this obstacle. The preliminary studies indicated that the use of PSMA-targeted scanning is more cost efficient than conventional imaging modalities for high-risk PCa patients. Furthering the development of imaging agents that target PCa-associated receptors and molecules could improve PET-based diagnosis of PCa.

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Performance of 18F-DCFPyL PET/CT Imaging in Early Detection of Biochemically Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis

Cited by 18 publications

References 56 publications

Comparing the diagnostic performance of radiotracers in prostate cancer biochemical recurrence: a systematic review and meta-analysis

Comparing the diagnostic performance of radiotracers in prostate cancer biochemical recurrence: a systematic review and meta-analysis

Comparing digital to analog prostate-specific membrane antigen-targeted piflufolastat 18F PET/CT in prostate cancer patients in early biochemical failure

The Performance of FDA-Approved PET Imaging Agents in the Detection of Prostate Cancer

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