PSMA PET vs. mpMRI for Lymph Node Metastasis of Prostate Cancer: A Systematic Review and Head-to-Head Comparative Meta-analysis.

IF 3.8 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Bin Yang, Hao Dong, Shuwei Zhang, Shaoxing Ming, Rui Yang, Yonghan Peng, Xiaofeng Gao
{"title":"PSMA PET vs. mpMRI for Lymph Node Metastasis of Prostate Cancer: A Systematic Review and Head-to-Head Comparative Meta-analysis.","authors":"Bin Yang, Hao Dong, Shuwei Zhang, Shaoxing Ming, Rui Yang, Yonghan Peng, Xiaofeng Gao","doi":"10.1016/j.acra.2024.11.029","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare prostate-specific membrane antigen (PSMA) PET with multiparametric MRI (mpMRI) in the diagnosis of lymph node metastasis (LNM) in prostate cancer.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, and Web of Science identified studies published up to August 24, 2024. Studies comparing PSMA PET and mpMRI accuracy in detecting LNM in prostate cancer were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Performance Studies-2 tool.</p><p><strong>Results: </strong>This study included 23 articles with a total of 3041 patients. The pooled analysis showed PSMA PET had a sensitivity of 0.74 (95% CI:0.62-0.85) and specificity of 0.96 (95% CI:0.93-0.98) for detecting prostate cancer LNM, while mpMRI had a sensitivity of 0.45 (95% CI:0.32-0.57) and specificity at 0.92 (95% CI:0.86-0.97). PSMA PET shows notably higher sensitivity than mpMRI, (P < 0.01) with no significant difference in specificity (P = 0.18). For initial staging, PSMA PET shows significantly higher sensitivity than mpMRI (P < 0.01), with no significant specificity difference (P = 0.17). Subgroup analysis showed that both [<sup>68</sup>Ga]Ga-PSMA-11 PET and [<sup>18</sup>F]F-PSMA-1007 PET had higher sensitivity than mpMRI (P = 0.03, P < 0.01) without significant differences in specificity (P = 0.10, P = 0.73). Meanwhile, there was no significant difference in the sensitivity (P = 0.20) and specificity (P = 0.43) of [<sup>18</sup>F]F-DCFPyL PET.</p><p><strong>Conclusion: </strong>PSMA PET is more sensitive than mpMRI in detecting LNM in prostate cancer, especially for initial staging; however, there is no significant difference in specificity between the two. Due to the high heterogeneity, more subgroup-based studies are needed to standardize imaging practices and validate these findings.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.acra.2024.11.029","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: To compare prostate-specific membrane antigen (PSMA) PET with multiparametric MRI (mpMRI) in the diagnosis of lymph node metastasis (LNM) in prostate cancer.

Methods: A comprehensive search of PubMed, Embase, and Web of Science identified studies published up to August 24, 2024. Studies comparing PSMA PET and mpMRI accuracy in detecting LNM in prostate cancer were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Performance Studies-2 tool.

Results: This study included 23 articles with a total of 3041 patients. The pooled analysis showed PSMA PET had a sensitivity of 0.74 (95% CI:0.62-0.85) and specificity of 0.96 (95% CI:0.93-0.98) for detecting prostate cancer LNM, while mpMRI had a sensitivity of 0.45 (95% CI:0.32-0.57) and specificity at 0.92 (95% CI:0.86-0.97). PSMA PET shows notably higher sensitivity than mpMRI, (P < 0.01) with no significant difference in specificity (P = 0.18). For initial staging, PSMA PET shows significantly higher sensitivity than mpMRI (P < 0.01), with no significant specificity difference (P = 0.17). Subgroup analysis showed that both [68Ga]Ga-PSMA-11 PET and [18F]F-PSMA-1007 PET had higher sensitivity than mpMRI (P = 0.03, P < 0.01) without significant differences in specificity (P = 0.10, P = 0.73). Meanwhile, there was no significant difference in the sensitivity (P = 0.20) and specificity (P = 0.43) of [18F]F-DCFPyL PET.

Conclusion: PSMA PET is more sensitive than mpMRI in detecting LNM in prostate cancer, especially for initial staging; however, there is no significant difference in specificity between the two. Due to the high heterogeneity, more subgroup-based studies are needed to standardize imaging practices and validate these findings.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Academic Radiology
Academic Radiology 医学-核医学
CiteScore
7.60
自引率
10.40%
发文量
432
审稿时长
18 days
期刊介绍: Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信