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The Diagnostic Performance of 68Ga-PSMA-11 PET/MRI for the Biochemically Recurrent Prostate Cancer: A Systematic
Dan Wang1, Zong-Hao Wang1, Chun-Bao Wang1
1School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
Background:
Our meta-analysis aimed to evaluate the diagnostic performance of 68Ga-PSMA-11 PET/MRI for biochemical recurrence of prostate cancer.
Methods:
We systematically and comprehensively searched all available studies until May 2023 in the PubMed and Embase databases. Studies evaluating 68Ga-PSMA-11 PET/MRI in men with prostate cancer biochemical recurrence were included. We appraised the quality of studies using a tailored Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. For each meta-analysis, we used the DerSimonian and Laird method. We first transformed proportions with the Freeman-Tukey double arcsine transformation, and then confidence intervals were calculated using the Jackson method. Meta-regression and sensitivity analysis were conducted to explore heterogeneity sources. Furthermore, we conducted subgroup analysis according to the PSA levels.
Results:
Overall, 13 studies with 738 patients were included in the analysis. The pooled overall detection rates of 68Ga-PSMA-11 PET/MRI in detecting recurrent PCa after definitive treatment were 74% (95% CI, 68%-79%). For patients with PSA under 0.5 ng/mL, the detection rate was 55 %. The detection rates were 79 %, 76 % and 87 % for the subgroup PSA levels of 0.5-0.99, 1.0-1.99 and over 2.0 ng/mL.
Conclusion:
68Ga-PSMA-11 PET/MRI has a good detection rate for biochemical recurrence of prostate cancer. However, large sample, multi-center studies are still needed to verify and expand on our conclusion.
Insights
This meta-analysis shows Gallium-68 PSMA-11 PET/MRI effectively detects prostate cancer recurrence. Detection rates vary by PSA levels, highlighting its utility in managing biochemical recurrence.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Prostate cancer (PCa) recurrence after treatment poses a significant clinical challenge.
- Accurate detection of biochemical recurrence is crucial for timely management decisions.
Purpose of the Study:
- To evaluate the diagnostic performance of Gallium-68 PSMA-11 PET/MRI (68Ga-PSMA-11 PET/MRI) for detecting biochemical recurrence of prostate cancer.
- To synthesize evidence from existing studies on the efficacy of 68Ga-PSMA-11 PET/MRI in recurrent prostate cancer.
Main Methods:
- Systematic literature search of PubMed and Embase databases up to May 2023.
- Inclusion of 13 studies involving 738 patients with prostate cancer biochemical recurrence.
- Quality assessment using QUADAS-2 tool and meta-analysis employing DerSimonian and Laird method.
Main Results:
- The pooled overall detection rate of 68Ga-PSMA-11 PET/MRI for recurrent prostate cancer was 74%.
- Detection rates were lower in patients with PSA < 0.5 ng/mL (55%) compared to higher PSA levels (79%-87%).
Conclusions:
- 68Ga-PSMA-11 PET/MRI demonstrates a good detection rate for biochemical recurrence in prostate cancer.
- Further large-scale, multi-center studies are warranted to validate these findings and expand clinical application.
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