World J Mens Health.  2020 Apr;38(2):208-219. 10.5534/wjmh.180124.

Diagnostic Performance of 68Gallium Labelled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Magnetic Resonance Imaging for Staging the Prostate Cancer with Intermediate or High Risk Prior to Radical Prostatectomy: A Systematic Review and Meta-analysis

• Wu H
• Xu T
• Wang X
• Yu YB
• Fan ZY
• Li DX
• Luo L
• Yang XC
• Jiao W
• Niu HT

• KMID: 2471827
• DOI: http://doi.org/10.5534/wjmh.180124

Abstract

PURPOSE
To compare the diagnostic efficiency of ⁶⁸Gallium labelled prostate-specific membrane antigen positron emission tomography (⁶⁸Ga-PSMA PET) and magnetic resonance imaging (MRI) for staging the lymph node metastases (LNMs) in the prostate cancer.
MATERIALS AND METHODS
A broad search of scientific databases including PubMed, EMBASE, Web of Science, Cochrane Database, and Chinese Biomedicine Literature Database (updated prior to November 1st, 2018) was conducted systematically by two reviewers. In this paper, we evaluated the methodological quality of each included article independently and performed a systematic review and meta-analysis to reveal the summary of the diagnostic performance of ⁶⁸Ga-PSMA PET and MRI in properly identifying LNMs of intermediate- and/or high-risk prostate cancer.
RESULTS
Thirteen eligible articles comprising 1,597 patients were included. For LNMs detection, the pooled sensitivity and specificity of ⁶⁸Ga-PSMA PET were 0.65 (95% confidence interval [CI]: 0.49-0.79) and 0.94 (95% CI: 0.88-0.97), respectively, while the corresponding values of MRI were 0.41 (95% CI: 0.26-0.57) and 0.92 (95% CI: 0.86-0.95). The area under the symmetric receiver-operating characteristic (SROC) curve for ⁶⁸Ga-PSMA PET and MRI were 0.92 and 0.83, respectively.
CONCLUSIONS
In intermediate- or high-risk pre-treatment prostate cancer, ⁶⁸Ga-PSMA PET had a higher sensitivity and a slightly different specificity in probing the LNMs when comparing with MRI. Moreover, the area under the SROC curve indicated that ⁶⁸Ga-PSMA PET was a more effective weapon for predicting the LNMs prior to radical surgery.

Keyword

Prostate cancer; Positron-emission tomography; Meta-analysis; Metastasis; Magnetic resonance imaging

MeSH Terms

Asian Continental Ancestry Group
Electrons*
Humans
Lymph Nodes
Magnetic Resonance Imaging*
Membranes*
Neoplasm Metastasis
Positron-Emission Tomography
Prostate*
Prostatectomy*
Prostatic Neoplasms*
Sensitivity and Specificity
Weapons

Figure

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  Fig. 1 Flow diagram of the literature search.

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  Fig. 2 The detail of risk of bias.

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  Fig. 3 Forest plot concluded the sensitivity and specificity of the two modalities. (A) the diagnostic performance of 68Gallium positron emission tomography group; (B) the diagnostic performance of magnetic resonance imaging.

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  Fig. 4 Symmetric receiver-operating characteristic (SROC) curve. (A) 68Gallium-prostate-specific membrane antigen positron emission tomography/computed tomography; (B) magnetic resonance imaging group. SENS: sensitivity, SPEC: specificity, AUC: area under the curve.

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  Fig. 5 Funnel Plot of publication bias. (A) 68Gallium-prostate-specific membrane antigen positron emission tomography/computed tomography; (B) magnetic resonance imaging. ESS: effective sample size.

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