Comparison of 18F-based PSMA radiotracers with [68Ga]Ga-PSMA-11 in PET/CT imaging of prostate cancer-a systematic review and meta-analysis
Journal Title
Prostate Cancer and Prostatic Diseases
Publication Type
Online publication before print
Abstract
BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) has become an increasingly established imaging modality in the staging of prostate cancer (PCa). Numerous PSMA-based tracers are currently available, however, there is a lack of consensus on the optimal radiotracer(s) for PSMA PET/CT. This study aims to investigate whether Fluorine-18 ((18)F)-labelled PSMA PET/CT is significantly different from Gallium-68 ((68)Ga) in primary diagnosis and/or secondary staging of prostate cancer following biochemical recurrence. METHODS: A critical review of MEDLINE, EMBASE, PubMed and Web of Science databases was performed in May 2023 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Studies that directly compared (18)F-based PSMA radiotracers and [(68)Ga]Ga-PSMA-11 in terms of the normal organ SUV or the lesion SUV or the detection rate were assessed. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). RESULTS: Twenty-four studies were analysed. [(18)F]DCFPyL and [(18)F]PSMA-1007 were the two most commonly studied (18)F based PSMA tracers. [(18)F]JK-PSMA-7, [(18)F]rhPSMA-7, [(18)F]AlF-PSMA-11 were the new tracers evaluated in a limited number of studies. Overall, [(18)F]DCFPyL was observed to have a similar lesion detection rate to [(68)Ga]Ga-PSMA-11 with no increase in false positive rates. [(18)F]PSMA-1007 was found to have a greater local lesion detection rate because of its predominant hepatobiliary excretory route. However, [(68)Ga]Ga-PSMA-11 was observed to have a similar local lesion detection rate in studies that administer patients with furosemide prior to the scan. In addition, [(18)F]PSMA-1007 was found to have a significant number of benign bone uptakes. CONCLUSIONS: [(18)F]DCFPyL was observed to be similar to [(68)Ga]Ga-PSMA-11. [(18)F]PSMA-1007 was observed to be less preferrable to [(68)Ga]Ga-PSMA-11 due to its high benign bone uptakes. Overall, there was not enough evidence in differentiating the radiotracers based on their clinical impacts.
Department(s)
Cancer Imaging; Surgical Oncology
Open Access at Publisher's Site
https://doi.org/10.1038/s41391-023-00755-2
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Creation Date: 2023-12-20 12:18:41
Last Modified: 2023-12-20 12:24:05

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