PET/MRI in prostate cancer: a systematic review and meta-analysis.

In recent years, the clinical availability of scanners for integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) has enabled the practical potential of multimodal, combined metabolic-receptor, anatomical, and functional imaging to be explored. The present systematic review and meta-analysis summarize the diagnostic information provided by PET/MRI in patients with prostate cancer (PCa).

A literature search was conducted in three different databases. The terms used were "choline" or "prostate-specific membrane antigen - PSMA" AND "prostate cancer" or "prostate" AND "PET/MRI" or "PET MRI" or "PET-MRI" or "positron emission tomography/magnetic resonance imaging." All relevant records identified were combined, and the full texts were retrieved. Reports were excluded if (1) they did not consider hybrid PET/MRI; or (2) the sample size was < 10 patients; or (3) the raw data were not enough to enable the completion of a 2 × 2 contingency table.

Fifty articles were eligible for systematic review, and 23 for meta-analysis. The pooled data concerned 2104 patients. Initial disease staging was the main indication for PET/MRI in 24 studies. Radiolabeled PSMA was the tracer most frequently used. In primary tumors, the pooled sensitivity for the patient-based analysis was 94.9%. At restaging, the pooled detection rate was 80.9% and was higher for radiolabeled PSMA than for choline (81.8% and 77.3%, respectively).

PET/MRI proved highly sensitive in detecting primary PCa, with a high detection rate for recurrent disease, particularly when radiolabeled PSMA was used.

European journal of nuclear medicine and molecular imaging. 2020 Sep 08 [Epub ahead of print]

Laura Evangelista, Fabio Zattoni, Gianluca Cassarino, Paolo Artioli, Diego Cecchin, Fabrizio Dal Moro, Pietro Zucchetta

Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy. ., Urology Unit, Department of Medicine, Udine University Hospital, Udine, Italy., Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy.