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A systematic review and meta-analysis to evaluate the diagnostic accuracy of PSMA PET/CT in the initial staging of prostate cancer
A. Mari, A. Cadenar, S. Giudici, G. Cianchi, S. Albisinni, R. Autorino, F. Di Maida, G. Gandaglia, MC. Mir, M. Valerio, G. Marra, F. Zattoni, L. Bianchi, R. Lombardo, SF. Shariat, M. Roupret, M. Bauckneht, L. Vaggelli, C. De Nunzio, A. Minervini
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, systematický přehled, metaanalýza, přehledy
- MeSH
- antigeny povrchové MeSH
- glutamátkarboxypeptidasa II * metabolismus MeSH
- lidé MeSH
- nádory prostaty * patologie diagnostické zobrazování MeSH
- PET/CT * metody MeSH
- senzitivita a specificita MeSH
- staging nádorů * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND: Positron Emission Tomography-Computed Tomography using Prostate-Specific Membrane Antigen (PSMA PET/CT) is notable for its superior sensitivity and specificity in detecting recurrent PCa and is under investigation for its potential in pre-treatment staging. Despite its established efficacy in nodal and metastasis staging in trial setting, its role in primary staging awaits fuller validation due to limited evidence on oncologic outcomes. This systematic review and meta-analysis aims to appraise the diagnostic accuracy of PSMA PET/CT compared to CI for comprehensive PCa staging. METHODS: Medline, Scopus and Web of science databases were searched till March 2023. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies. Primary outcomes were specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of PSMA PET/CT for local, nodal and metastatic staging in PCa patients. Due to the unavailability of data, a meta-analysis was feasible only for detection of seminal vesicles invasion (SVI) and LNI. RESULTS: A total of 49 studies, comprising 3876 patients, were included. Of these, 6 investigated accuracy of PSMA PET/CT in detection of SVI. Pooled sensitivity, specificity, PPV and NPV were 42.29% (95%CI: 29.85-55.78%), 87.59% (95%CI: 77.10%-93.67%), 93.39% (95%CI: 74.95%-98.52%) and 86.60% (95%CI: 58.83%-96.69%), respectively. Heterogeneity analysis revealed significant variability for PPV and NPV. 18 studies investigated PSMA PET/CT accuracy in detection of LNI. Aggregate sensitivity, specificity, PPV and NPV were 43.63% (95%CI: 34.19-53.56%), 85.55% (95%CI: 75.95%-91.74%), 67.47% (95%CI: 52.42%-79.6%) and 83.61% (95%CI: 79.19%-87.24%). No significant heterogeneity was found between studies. CONCLUSIONS: The present systematic review and meta-analysis highlights PSMA PET-CT effectiveness in detecting SVI and its good accuracy in LNI compared to CI. Nonetheless, it also reveals a lack of high-quality research on its performance in clinical T staging, extraprostatic extension and distant metastasis evaluation, emphasizing the need for further rigorous studies.
Department of Health Sciences University of Genoa Genoa Italy
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Hospital Universitario La Ribera Valencia Spain
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology Rush University Medical Center Chicago IL USA
Department of Urology Sant'Andrea Hospital Sapienza University Rome Italy
Department of Urology University Hospital of Geneva Geneva Switzerland
Department of Urology University of Texas Southwestern Dallas TX USA
Department of Urology Weill Cornell Medical College New York NY 10065 USA
Department Surgery Oncology and Gastroenterology Urologic Unit University of Padova Padova Italy
Division of Urology IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
European Association of Urology Research Foundation Arnhem The Netherlands
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordanien
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Nuclear Medicine Division Careggi University Hospital Florence Italy
Nuclear Medicine IRCCS Ospedale Policlinico San Martino Genoa Italy
Citace poskytuje Crossref.org
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