The Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Magnetic Resonance Imaging in Primary and Recurrent Prostate Cancer: A Systematic Review of the Literature.

Prostate-specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) is a novel imaging technique with several potential applications in the prostate cancer (PCa) setting.

To perform a systematic review of the current evidence regarding the diagnostic performance of PSMA PET/MRI in patients with primary and recurrent PCa.

A comprehensive bibliographic search on the MEDLINE and Cochrane Library databases was performed in October 2020. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Studies were deemed eligible if they assessed patients with primary or recurrent PCa (P) undergoing PSMA PET/MRI (I) with or without comparison with other imaging techniques (C) in order to evaluate its diagnostic performance (O). Retrospective and prospective primary clinical studies were included. Results of previous meta-analyses were reported.

A total of 23 original articles and three meta-analyses were included. Limited evidence on PSMA PET/MRI is available, especially in the setting of partial gland ablation. PET/MRI can be an effective imaging modality for detecting primary PCa, showing higher accuracy than multiparametric MRI alone. It provides accurate local staging of primary PCa; however, there are contradictory results in this context when its performance is compared with other imaging techniques. PET/MRI also shows high performance for restaging and detecting tumor recurrence, even at low prostate-specific antigen levels.

PSMA PET/MRI could represent a valuable tool in the management of patients with primary and recurrent PCa. No specific recommendations can be provided.

Encouraging data regarding the benefits of prostate-specific membrane antigen positron emission tomography/magnetic resonance imaging in patients with prostate cancer are emerging from the literature.

European urology focus. 2021 Sep 15 [Epub ahead of print]

Celeste Manfredi, Esaú Fernández-Pascual, Davide Arcaniolo, Mark Emberton, Rafael Sanchez-Salas, Carlos Artigas Guix, Fernando Bianco, Paul Cathcart, Declan G Murphy, Felipe Couñago, Claudio Martínez-Ballesteros, Paolo Verze, Juan Ignacio Martínez-Salamanca

Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy., Department of Urology, Hospital Universitario La Paz, Madrid, Spain; LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain., Division of Surgery and Interventional Science, University College London, London, UK., Department of Urology, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France., Nuclear Medicine Department, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Bruxelles, Belgium., Urological Research Network, Nova University, Miami, FL, USA., Department of Urology, Guy's and St Thomas NHS Foundation Trust, London, UK., Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia., Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Madrid, Spain., LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain; Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, Madrid, Spain., Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy., LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain; Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, Madrid, Spain. Electronic address: .

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