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68Ga-PSMA PET in prostate cancer: a systematic review and meta-analysis of the observer agreement

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The performance of 68 Ga-PSMA PET/CT-MR has been evaluated in prostate cancer (PCa), showing significant results. However, even a technically accurate imaging procedure requires a high interobserver agreement in its interpretation to implement in patients’ management. This study aims to perform a systematic review and meta-analysis on the interobserver variability in 68 Ga-PSMA PET/CT-MR imaging in PCa patients.

Methods

We conducted a systematic review and meta-analysis on the interobserver variability, including studies: (1) providing Kappa (K) as the inter-observer agreement test or the essential data to calculate it, (2) providing the K confidence interval or the essential crude data to calculate it, (3) measuring K statistic based on the appropriate use criteria for the inter-observer agreement.

Results

Twelve studies, providing 1585 68 Ga-PSMA PET/CT-MR studies reviewed by 62 independent readers, were included. In general, the pooled inter-observer agreement was interpreted as substantial for all analyzed groups, including tumoral lesions in the prostate bed, lymphadenopathies, bone metastasis, and soft-tissue metastasis (all between 0.6 and 0.8). The regional lymphadenopathy group (0.74) obtained the highest agreement, while the lowest was for soft tissue metastasis (0.65).

Conclusion

This study showed a substantial interobserver agreement in the overall interpretation and detecting locoregional and distant involvement with 68 Ga-PSMA PET/CT-MR in PCa patients.

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Data availability

The detailed data generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Mohammadreza Chavoshi

  2. Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Seyed Ali Mirshahvalad

  3. University Health Network, Toronto, Canada

    Seyed Ali Mirshahvalad, Ur Metser & Patrick Veit-Haibach

  4. Dept. Medical Imaging, University of Toronto, Toronto, Canada

    Ur Metser & Patrick Veit-Haibach

Authors
  1. Mohammadreza Chavoshi
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  2. Seyed Ali Mirshahvalad
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  3. Ur Metser
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  4. Patrick Veit-Haibach
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Corresponding author

Correspondence to Seyed Ali Mirshahvalad.

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Conflict of interest

Patrick Veit-Haibach has received grants from Bayer Switzerland, Roche Pharmaceuticals, Siemens Healthineers, and GE Healthcare. Also, he has received speaker fees and travel support from Siemens Healthineers and GE Healthcare.

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Key points

Qestion: Is 68 Ga-PSMA imaging a reproducible modality?

Pertinent finding: By including 12 articles in this meta-analysis, we found a substantial observer agreement in the 68 Ga-PSMA PET interpretations.

Implications for the patient care: This study showed that the 68 Ga-PSMA PET imaging is not an observer dependent modality. Knowing about this level of precision can help to reach a confident final judgement in the prostate cancer patients.

This article is part of the Topical Collection on Oncology—Genitourinary

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Chavoshi, M., Mirshahvalad, S.A., Metser, U. et al. 68Ga-PSMA PET in prostate cancer: a systematic review and meta-analysis of the observer agreement. Eur J Nucl Med Mol Imaging 49, 1021–1029 (2022). https://doi.org/10.1007/s00259-021-05616-5

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  • DOI: https://doi.org/10.1007/s00259-021-05616-5

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