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68Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) for primary staging of high-risk prostate cancer: a systematic review

Abstract

Purpose

To systematically review currently available data on 68Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) used for the primary staging of high-risk prostate cancer.

Methods

We performed critical reviews of EMBASE, Web of Science (including MEDLINE) and Cochrane databases in October 2016 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. We included studies that utilized 68Ga-PSMA PET for primary staging of prostate cancer. Quality was assessed using the Critical Appraisal Skills Programme checklist for diagnostic test studies.

Results

Following our systematic search strategy, 12 studies were included for assessment. These studies comprised a total of 322 patients who underwent 68Ga-PSMA PET scanning for the purpose of primary staging. Only 5 of these studies included histopathologic correlation data. High variation in methodology and outcomes such as sensitivity (range 33–99%) and specificity (> 90%) was seen across all studies. The ability of 68Ga-PSMA PET to detect malignant lesions was evident across studies, with most studies demonstrating increased detection rates with respect to conventional imaging modalities.

Conclusions

In the primary staging of prostate cancer 68Ga-PSMA PET appears to outperform traditional imaging modalities. Overall, there are few high-quality studies investigating 68Ga-PSMA PET in this sub-group highlighting the need for formal assessment of PSMA PET in the form of large-volume, prospective studies.

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Acknowledgements

We would like to acknowledge the support of the Young urology researchers organisation (YURO) community of Australia and New Zealand for enabling this manuscript to progress to completion.

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All authors in the submitted article have made a substantial contribution to the information submitted for publication. JC: protocol/project development, data collection or management, data analysis, manuscript writing/editing. MP: protocol/project development, data collection or management, data analysis, manuscript writing/editing. DB: protocol/project development. NL: protocol/project development, Manuscript writing/editing.

Corresponding author

Correspondence to Julia Corfield.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Corfield, J., Perera, M., Bolton, D. et al. 68Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) for primary staging of high-risk prostate cancer: a systematic review. World J Urol 36, 519–527 (2018). https://doi.org/10.1007/s00345-018-2182-1

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Keywords

  • Prostate cancer
  • Imaging
  • Positron emission tomography
  • Prostate-specific membrane antigen
  • PSMA