The Role of 18F PSMA-1007 PET/CT in the Staging and Detection of Recurrence of Prostate Cancer, A Scoping Review

To determine and review the currently available literature behind the staging capabilities of 18F-PSMA-1007 PET/CT in the setting of initial staging and detection of recurrent disease for patients with prostate cancer. Prostate cancer (PCa), one of the most diagnosed malignancies affecting adult men worldwide, requires accurate staging and early detection of recurrent disease to guide treatment decisions and improve oncological outcomes. 18F-PSMA-1007 PET/CT is a novel radiotracer with favorable imaging characteristics suggesting an important role within the Prostate Cancer management landscape.

The Arksey and O'Malley Framework was used to guide this review. PubMed/MEDLINE, EMBASE, EBSCO, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were used, and relevant titles were screened for eligibility.

404 database results were returned; 343 titles were excluded due to irrelevance and duplicates. A total of 61 papers were included for title and abstract review with a subsequent 26 excluded due to not meeting the inclusion criteria. A total of 35 papers proceeded to full-text review and 35 papers were included in this review. Evidence was grouped under three major themes: (1) The role of 18F-PSMA-1007 PET/CT in Initial staging; (2) The role of 18F-PSMA-1007 PET/CT in the detection of recurrent Prostate Cancer and (3) The Role of 18F-PSMA-1007 PET/CT in Salvage Therapy. The findings suggest 18F-PSMA-1007 PET/CT has superior diagnostic accuracy and sensitivity for the initial staging of prostate cancer compared with conventional imaging and other commonly used radiotracers. Strengths included the detection of pelvic and locoregional disease. Limitations included poor specificity for the detection of bone lesions, inconsistent urinary excretion patterns, and high inter-reader variability.

18F-PSMA-1007 PET/CT demonstrates superior diagnostic accuracy and sensitivity in both initial staging and detection of prostate cancer recurrence; however, it is limited by poor specificity for bone lesions and inconsistent urinary excretion patterns. Prospective multicenter trials are required to clearly delineate its role in the initial staging of prostate cancer and detection of recurrent disease.