[68Ga]Ga-PSMA Versus [18F]PSMA Positron Emission Tomography/Computed Tomography in the Staging of Primary and Recurrent Prostate Cancer. A Systematic Review of the Literature

Evangelista, L; Maurer, T; van der Poel, H; Alongi, F; Kunikowska, J; Laudicella, R; Fanti, S; Hofman, MS

Author(s): Evangelista, L; Maurer, T; van der Poel, H; Alongi, F; Kunikowska, J; Laudicella, R; Fanti, S; Hofman, MS;
Details: Publication Year 2022-06,Volume 5,Issue #3,Page 273-282
Journal Title: European Urology Oncology
Publication Type: Review
Abstract: CONTEXT: In the past 10 yr, several agents based on prostate-specific membrane antigen (PSMA) for positron emission tomography imaging have been introduced in clinical practice for the management of patients with prostate cancer (PCa). OBJECTIVE: To analyse the available data in the literature to clarify the advantages and disadvantages of [(68)Ga]Ga-PSMA and [(18)F]PSMA in different settings of PCa. EVIDENCE ACQUISITION: A systematic literature search was made by using two main databases. Only studies published in the past 5 yr (2016-2021) in the English language with >20 enrolled patients were selected. Two reviewers independently appraised each article using a standard protocol. All the studies were analysed using a modified version of the Critical Appraisal Skills Programme checklist for diagnostic test studies. EVIDENCE SYNTHESIS: The systematic evaluation was made in 12 papers. Based on the quality assessment, the analysed studies demonstrated different methodologies. Three papers focused on the head-to-head comparison between (18)F- and [(68)Ga]Ga-PSMA (n = 123 patients). A matched-pair comparison between (18)F- and [(68)Ga]Ga-PSMA was reported in three papers, including 715 patients. The remaining papers used indiscriminately either (68)Ga-PSMA or [(18)F]PSMA (n = 1.157 patients). [(18)F]PSMA-1007 is superior to [(68)Ga]Ga-PSMA-11 for the identification of local recurrence (less activity close to the bladder for [(18)F]PSMA-1007). Nonspecific/equivocal bone lesions are often recognised at [(18)F]PSMA-1007. [(18)F]DCFPyL is more reproducible for the identification of lymph nodes, and it shows fewer equivocal skeletal lesions and higher inter-reader agreement on skeletal lesions. CONCLUSIONS: Despite a large body of literature on PSMA radiopharmaceutical agents labelled with (68)Ga or (18)F, there are limited head-to-head or matched-pair comparative data. Certain clinical indications could trigger a preference, whilst caution is needed in interpreting potential false-positive findings, especially with [(18)F]PSMA-1007. Given the excellent performance of all accessible radiopharmaceuticals, the availability of specific tracers will likely guide choice. PATIENT SUMMARY: In this systematic review, we analysed the currently available literature focused on [(68)Ga] and [(18)F]-labelled prostate-specific membrane antigen. Our purpose is to identify which tracers would be correctly employed for the management of patients with prostate cancer.
Keywords: Gallium Isotopes; *Gallium Radioisotopes; Humans; Male; Neoplasm Recurrence, Local; Positron Emission Tomography Computed Tomography/methods; *Prostatic Neoplasms/diagnostic imaging/pathology; Radiopharmaceuticals; Disease management; Matched-pair analysis; Prostate cancer; Prostate-specific membrane antigen positron emission tomography; [(18)f]psma; [(68)Ga]Ga-PSMA-11
Department(s): Cancer Imaging
PubMed ID: 35367165
Publisher's Version: https://doi.org/10.1016/j.euo.2022.03.004
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-24 04:09:59

Last Modified: 2024-10-24 04:10:44