Abstract
BACKGROUND: PSMA PET is a promising method for primary lymph node staging in prostate cancer. However, recent systematic reviews have identified only a limited number of studies with histopathology as a reference test.
METHODS: A systematic search was performed in PubMed and the Cochrane Library. An expedited systematic review was performed where we identified diagnostic studies in prostate cancer where a preoperative PSMA PET for primary lymph node staging was compared to histopathology. The trials must have diagnostic data on a patient level.
RESULTS: Eighteen eligible clinical trials included 969 patients. The median patient number per study was 32 (range 10 to 208). Five trials were prospective, and nine trials had a consecutive enrolment of patients. Sixteen studies used Ga-68-PSMA-11; there was one study with Cu-64-PSMA and one study with F-18-DCDFPyL. Twelve studies used PET/CT, four trials used PET/MR. Most trials included patients with intermediate and high-risk. Diagnostic accuracy varied notably among the studies; sensitivity ranged from 23 to 100%, specificity 67-100%, positive predictive value 20-100%, and negative predictive value 41-100%. Weighted sensitivity was 59%, weighted specificity was 93%. Four studies compared PSMA PET with anatomical imaging (CT or MRI); in all cases, sensitivity and specificity were superior with PSMA PET. Three studies compared PSMA PET with multi-parametric or diffusion-weighted MRI with mixed results.
CONCLUSIONS: PSMA PET showed promising diagnostic accuracy for primary lymph node staging with pathology as reference. Recommendation for PSMA PET for high-risk patients in clinical guidelines should be supported by confirmatory, prospective trials with patient-relevant outcomes.
Originalsprog | Engelsk |
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Artikelnummer | 10 |
Tidsskrift | Cancer Imaging |
Vol/bind | 20 |
Udgave nummer | 1 |
Antal sider | 8 |
ISSN | 1740-5025 |
DOI | |
Status | Udgivet - 23 jan. 2020 |
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MOESM1 of PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review
Petersen, L. J. (Ophavsperson) & Zacho, H. D. (Ophavsperson), Figshare, 24 jan. 2020
DOI: 10.6084/m9.figshare.11706834.v1, https://springernature.figshare.com/articles/MOESM1_of_PSMA_PET_for_primary_lymph_node_staging_of_intermediate_and_high-risk_prostate_cancer_an_expedited_systematic_review/11706834/1
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MOESM1 of PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review
Petersen, L. J. (Ophavsperson) & Zacho, H. D. (Ophavsperson), Figshare, 2020
DOI: 10.6084/m9.figshare.11706834, https://springernature.figshare.com/articles/MOESM1_of_PSMA_PET_for_primary_lymph_node_staging_of_intermediate_and_high-risk_prostate_cancer_an_expedited_systematic_review/11706834
Datasæt
-
PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review
Petersen, L. J. (Ophavsperson) & Zacho, H. D. (Ophavsperson), Figshare, 2020
DOI: 10.6084/m9.figshare.c.4829019, https://springernature.figshare.com/collections/PSMA_PET_for_primary_lymph_node_staging_of_intermediate_and_high-risk_prostate_cancer_an_expedited_systematic_review/4829019
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