PSMA PET/CT 等位骨病变:关于其发病率和恶变率的系统回顾和荟萃分析

IF 2.3 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Sungmin Woo, Daniel Freedman, Anton S. Becker, Doris Leithner, Marius E. Mayerhoefer, Kent P. Friedman, Yuki Arita, Sangwon Han, Irene A. Burger, Samir S. Taneja, David R. Wise, Michael J. Zelefsky, Hebert A. Vargas
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引用次数: 0

摘要

目的 前列腺特异性膜抗原(PSMA)PET/CT 在检测前列腺癌转移方面具有可靠的诊断性能。然而,越来越多的扫描结果显示骨病变不明确、无特异性摄取、无明确的良性或恶性 CT 相关性。迄今为止,这些等密度病变的发病率、恶性率以及与放射性配体类型([18F] PSMA-1007 与其他类型([68Ga]Ga-PSMA-11 和 [18F] DCFPyL)的关系尚未得到广泛证实。对截至 2023 年 12 月 11 日的 Pubmed 和 EMBASE 进行了检索。研究质量采用 QUADAS-2 进行评估。采用随机效应模型对以下比例进行了汇总:(1) 等位骨病变的发生率(即有一个或多个等位骨病变的患者人数/有 PSMA PET/CT 的患者人数);(2) 恶性肿瘤发生率(即转移的数量/等位骨病变的数量)。根据放射性配体类型、临床环境和等密度骨病变的定义进行了分组分析。汇总的等灶骨病变发生率为 20%(95%CI,12-31%)。与其他放射性配体相比,[18F]PSMA-1007 与更高的等灶病变发生率相关:分别为 36% (95%CI 26-48%) vs. 8% (95%CI, 4-14%), p <0.01。等位骨病变的汇总恶性率为 14%(95%CI,7-25%)。与其他放射性配体相比,[18F]PSMA-1007 的恶性肿瘤发生率较低:分别为 8%(95%CI,3-19%)与 29%(95%CI,17-44%),P = 0.01。根据临床环境或等密度骨病变的定义进行分层的亚组之间在患病率或恶性率方面没有显著差异(P = 0.32-0.60)。与其他放射性配体相比,[18F]PSMA-1007需要特别关注,因为它与较高的转移频率和较低的转移率相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Equivocal bone lesions on PSMA PET/CT: systematic review and meta-analysis on their prevalence and malignancy rate

Equivocal bone lesions on PSMA PET/CT: systematic review and meta-analysis on their prevalence and malignancy rate

Purpose

Prostate-specific membrane antigen (PSMA) PET/CT has an established reliable diagnostic performance for detecting metastases in prostate cancer. However, there are increasing instances of scans demonstrating equivocal bone lesions, with non-specific uptake and without a definite benign or malignant CT correlate. To date, the prevalence, malignancy rate, and relationship with radioligand type ([18F] PSMA-1007 vs. others ([68Ga]Ga-PSMA-11 and [18F] DCFPyL) for these equivocal lesions have not been extensively established.

Methods

A systematic review and meta-analysis was conducted on equivocal bone lesions. Pubmed and EMBASE were searched up to December 11, 2023. Quality of the studies was evaluated using QUADAS-2. The following proportions were pooled using random-effects model: (1) prevalence of equivocal bone lesions (i.e., number of patients with one or more equivocal bone lesions/number of patients with PSMA PET/CT) and (2) their malignancy rates (i.e., number of metastases/number of equivocal bone lesions). Subgroup analyses based on radioligand type, clinical setting, and definition of equivocal bone lesion were performed.

Results

Twenty-five studies (4484 patients) were included. Pooled prevalence of equivocal bone lesions was 20% (95%CI, 12–31%). [18F]PSMA-1007 was associated with a greater prevalence of equivocal lesions compared with other radioligands: 36% (95%CI 26–48%) vs. 8% (95%CI, 4–14%), respectively, p < 0.01. Pooled malignancy rate of equivocal bone lesions was 14% (95%CI, 7–25%). [18F]PSMA-1007 was associated with a lower malignancy rate compared to other radioligands: 8% (95%CI, 3–19%) vs. 29% (95%CI, 17–44%), respectively, p = 0.01. There were no signficant difference in prevalence or malignancy rate between subgroups stratified to clinical setting or definition of equivocal bone lesions (p = 0.32–0.60).

Conclusions

Equivocal bone lesions are often encountered on PSMA PET/CT but exihibit a low malignancy rate. Compared to other radioligands, [18F]PSMA-1007 requires special attention as it is associated with a higher frequency and lower rate of metastasis.

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来源期刊
Clinical and Translational Imaging
Clinical and Translational Imaging Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
3.60
自引率
4.80%
发文量
55
期刊介绍: Clinical and Translational Imaging is an international journal that publishes timely, up-to-date summaries on clinical practice and translational research and clinical applications of approved and experimental radiopharmaceuticals for diagnostic and therapeutic purposes. Coverage includes such topics as advanced preclinical evidence in the fields of physics, dosimetry, radiation biology and radiopharmacy with relevance to applications in human subjects. The journal benefits a readership of nuclear medicine practitioners and allied professionals involved in molecular imaging and therapy.
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