Prostate cancer (PC) is the second most commonly diagnosed cancer in males. 68Ga-PSMA PET/CT, a non-invasive diagnostic tool to evaluate PC with prostate-specific membrane antigen (PSMA) expression, has emerged as a more accurate alternative to assess disease staging. We aimed to identify predictors of positive 68Ga-PSMA PET and the accuracy of this technique.
Diagnostic accuracy cross-sectional study with prospective and retrospective approaches. We performed a comprehensive literature search on PubMed, Cochrane Library, and Embase database in search of studies including PC patients submitted to radical prostatectomy or radiotherapy with curative intent and presented biochemical recurrence following ASTRO 1996 criteria. A total of 35 studies involving 3910 patients submitted to 68-Ga-PSMA PET were included and independently assessed by two authors: 8 studies on diagnosis, four on staging, and 23 studies on restaging purposes. The significance level was α=0.05.
pooled sensitivity and specificity were 0.90 (0.86-0.93) and 0.90 (0.82-0.96), respectively, for diagnostic purposes; as for staging, pooled sensitivity and specificity were 0.93 (0.86-0.98) and 0.96 (0.92-0.99), respectively. In the restaging scenario, pooled sensitivity and specificity were 0.76 (0.74-0.78) and 0.45 (0.27-0.58), respectively, considering the identification of prostate cancer in each described situation. We also obtained specificity and sensitivity results for PSA subdivisions.
68Ga-PSMA PET provides higher sensitivity and specificity than traditional imaging for prostate cancer.
International braz j urol : official journal of the Brazilian Society of Urology. 2021 Feb 11 [Epub ahead of print]
Cristina S Matushita, Ana M Marques da Silva, Phelipi N Schuck, Matteo Bardisserotto, Diego B Piant, Jonatas L Pereira, Juliano J Cerci, George B Coura-Filho, Fabio P Esteves, Barbara J Amorim, Gustavo V Gomes, Ana Emília T Brito, Wanderley M Bernardo, Eduardo Mundstock, Stefano Fanti, Bruna Macedo, Diego H Roman, Cinthia Scatolin Tem-Pass, Bruno Hochhegger
Instituto do Cérebro do Rio Grande do Sul, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brasil., Laboratório de Imagens Médicas, Faculdade de Ciências, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brasil., Clínica Kozma - Balneário Camboriú, SC, Brasil., Instituto Hospital Erasto Gaertner, Curitiba, PR, Brasil., Quanta Diagnóstico e Terapia, Curitiba, PR, Brasil., Departamento de Medicina Nuclear, Instituto do Câncer de São Paulo, São Paulo, SP, Brasil., OncoPETscan, Blumenau, SC, Brasil., Departamento de Medicina Nuclear, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil., Núcleos Centro de Medicina Nuclear, Guará, SP, Brasil., Real Hospital Português de Beneficência, Pernambuco, PE, Brasil., Programa de Pós-Graduação em Medicina, Faculdade de Medicina - USP, São Paulo, SP, Brasil., Programa de Pós-Graduação em Saúde da Criança, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brasil., Department of Experimental, Diagnostic and Specialized Medicine-DIMES, University of Bologna, Bologna, Italy.