Academic radiology · 2025
Diagnostic Performance of PET/CT Using Different Radiotracers in Clinically Significant Primary Prostate Cancer: A Systematic Review and Network Meta-analysis.
СтатьяNetwork Meta-AnalysisСистематический обзорНазвание и аннотация: Перевод в очереди
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Chen Yiming, Zhang Xianlu, Bi Jianbin, Wang Jianfeng
Аннотация
RATIONALE AND OBJECTIVES: Positron emission tomography/computed tomography (PET/CT) is an important modality for the diagnosis of prostate cancer (PCa), yet the choice of radiotracers has not been clearly defined. This study aimed to compare the diagnostic performance of PET/CT using different radiotracers for clinically significant prostate cancer (csPCa) at both the patient level and lesion level.
MATERIALS AND METHODS: The PubMed, Embase, and Cochrane Library databases were searched to collect English studies published up to March 1, 2024. A total of nine radiotracers were included in the analysis: 18F-DCFBC, 18F-FACBC, 68Ga-RM26, 68Ga-PSMA-617, 18F-PSMA-1007, 68Ga-PSMA-11, 18F-DCFPyL, 18F-FCH, and 68Ga-RM2. Multiparametric magnetic resonance imaging (mpMRI) was included as an intermediary in constructing a network meta-analysis. The quality of the studies was assessed using the QUADAS-2 tool. Simultaneously, the top three diagnostic methods for each outcome were ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: A total of 19 studies, comprising 996 patients and 1123 lesions, were included in the final analysis. At the patient level, the three most optimal diagnostic methods were 18F-PSMA-1007 (SUCRA: 0.846), 68Ga-PSMA-11 (SUCRA: 0.795), and 18F-DCFPyL (SUCRA: 0.753). At the lesion level, the top three were 18F-PSMA-1007 (SUCRA: 0.986), 18F-DCFPyL (SUCRA: 0.846), and 68Ga-PSMA-11 (SUCRA: 065.2). In terms of diagnostic accuracy, 18F-PSMA-1007 outperformed mpMRI at both the patient level (RR=1.06, 95% CI: 1.01, 1.11) and the lesion level (RR=1.29, 95% CI: 1.15, 1.45).
CONCLUSION: PSMA-PET/CT demonstrated excellent detection rates for csPCa at both the patient and lesion levels, with 18F-PSMA-1007 showing the optimal diagnostic performance. Based on these findings, selecting PSMA-based radiotracers could enhance positive biopsy detection rates and guide localized treatments.
MATERIALS AND METHODS: The PubMed, Embase, and Cochrane Library databases were searched to collect English studies published up to March 1, 2024. A total of nine radiotracers were included in the analysis: 18F-DCFBC, 18F-FACBC, 68Ga-RM26, 68Ga-PSMA-617, 18F-PSMA-1007, 68Ga-PSMA-11, 18F-DCFPyL, 18F-FCH, and 68Ga-RM2. Multiparametric magnetic resonance imaging (mpMRI) was included as an intermediary in constructing a network meta-analysis. The quality of the studies was assessed using the QUADAS-2 tool. Simultaneously, the top three diagnostic methods for each outcome were ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: A total of 19 studies, comprising 996 patients and 1123 lesions, were included in the final analysis. At the patient level, the three most optimal diagnostic methods were 18F-PSMA-1007 (SUCRA: 0.846), 68Ga-PSMA-11 (SUCRA: 0.795), and 18F-DCFPyL (SUCRA: 0.753). At the lesion level, the top three were 18F-PSMA-1007 (SUCRA: 0.986), 18F-DCFPyL (SUCRA: 0.846), and 68Ga-PSMA-11 (SUCRA: 065.2). In terms of diagnostic accuracy, 18F-PSMA-1007 outperformed mpMRI at both the patient level (RR=1.06, 95% CI: 1.01, 1.11) and the lesion level (RR=1.29, 95% CI: 1.15, 1.45).
CONCLUSION: PSMA-PET/CT demonstrated excellent detection rates for csPCa at both the patient and lesion levels, with 18F-PSMA-1007 showing the optimal diagnostic performance. Based on these findings, selecting PSMA-based radiotracers could enhance positive biopsy detection rates and guide localized treatments.