Abstract
Background: The use of prostate-specific membrane antigen (PSMA)-targeted agents for staging prostate cancer (PCa) patients using positron emission tomography/computed tomography (PET/CT) is increasing worldwide. We performed a systematic review on the role of 18F-PSMA-1007 PET/CT in PCa staging to provide evidence-based data in this setting. Methods: A comprehensive computer literature search of PubMed/MEDLINE and Cochrane Library databases for studies using 18F-PSMA-1007 PET/CT in PCa staging was performed until 31 December 2020. Eligible articles were selected and relevant information was extracted from the original articles by two authors independently. Results: Eight articles (369 patients) evaluating the role of 18F-PSMA-1007 PET/CT in PCa staging were selected. These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of 18F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Overall, higher primary PCa aggressiveness was associated with higher 18F-PSMA-1007 uptake. When compared with other radiological and scintigraphic imaging methods, 18F-PSMA-1007 PET/CT had superior sensitivity in detecting metastatic disease and the highest inter-reader agreement. 18F-PSMA-1007 PET/CT showed similar results in terms of diagnostic accuracy for PCa staging compared with PET/CT with other PSMA-targeted tracers. Dual imaging with multi-parametric magnetic resonance imaging and 18F-PSMA-1007 PET/CT may improve staging of primary PCa. Notably, 18F-PSMA-1007-PET/CT may detect metastatic disease in a significant number of patients with negative standard imaging. Conclusions: 18F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging. Prospective multicentric studies are needed to confirm these findings.
Highlights
Prostate cancer (PCa) is the second most common cancer among men, representing a common cause of cancer death worldwide [1].A precise prostate cancer (PCa) staging through imaging methods is essential for correct disease management, as treatment options are different for localized PCa, locally advanced, or metastatic disease
A precise PCa staging through imaging methods is essential for correct disease management, as treatment options are different for localized PCa, locally advanced, or metastatic disease
Bone scintigraphy and conventional abdominal imaging are still recommended for staging intermediate- and high-risk PCa, but they are increasingly being replaced by new hybrid imaging modalities [2,3]
Summary
Prostate cancer (PCa) is the second most common cancer among men, representing a common cause of cancer death worldwide [1].A precise PCa staging through imaging methods is essential for correct disease management, as treatment options are different for localized PCa, locally advanced, or metastatic disease. Advanced imaging methods including positron-emission tomography/computed tomography (PET/CT) and positron-emission tomography/magnetic resonance imaging (PET/MRI) using different radiopharmaceuticals have showed relevant results for early detection of local and systemic spread of PCa, according to available evidence-based data [4]. Results: Eight articles (369 patients) evaluating the role of 18 F-PSMA-1007 PET/CT in PCa staging were selected These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of 18 F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Conclusions: 18 F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging
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