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Mapelli P, Ghezzo S, Spataro A, Bezzi C, Samanes Gajate AM, Chiti A, Picchio M. Systematic Review and Metanalysis on the Role of Prostate-Specific Membrane Antigen Positron Emission Tomography/Magnetic Resonance Imaging for Intraprostatic Tumour Assessment. Magn Reson Imaging Clin N Am 2023; 31:605-611. [PMID: 37741644 DOI: 10.1016/j.mric.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
The present systematic review and meta-analysis are focused on the diagnostic accuracy of PSMA PET/MRI in primary prostate cancer assessment. A literature search was conducted on the PubMed database using the terms "PSMA" AND "prostate cancer" or "prostate" AND "PET/MRI" or "PET MRI" or "PET-MRI" or "PET-MR" AND "primary" or "staging." Ten articles were eligible for analysis after applying the exclusion criteria. PET/MRI showed better diagnostic accuracy in detecting primary PCa compared to multiparametric (mp) MRI and PET alone. The pooled sensitivity and specificity of 68Ga-PSMA PET/MRI at the per-patient level were 0.976 (CI: 0.943-0.991) and 0.739 (CI: 0.437-0.912); respectively. PSMA PET/MRI has good sensitivity in detecting primary PCa, especially in patients with PIRADS 3 PCa.
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Affiliation(s)
- Paola Mapelli
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan 20132, Italy; Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
| | - Samuele Ghezzo
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan 20132, Italy; Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
| | - Alessandro Spataro
- Department of Biomedical and Dental Sciences and of Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Piazza Pugliatti 1, Messina 98122, Italy
| | - Carolina Bezzi
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan 20132, Italy; Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
| | - Ana Maria Samanes Gajate
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
| | - Arturo Chiti
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan 20132, Italy; Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
| | - Maria Picchio
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan 20132, Italy; Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy.
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Shin D, Yoon CE, Kwon HJ, Moon HW, Park YH, Cho HJ, Ha US, Hong SH, Park SY, Ha S, Hyun O J, Yoo IR, Park C, Chi DY, Lee JY. Irreversible electroporation for prostate cancer using PSMA PET-CT. Prostate Int 2023; 11:40-45. [PMID: 36910902 PMCID: PMC9995691 DOI: 10.1016/j.prnil.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/24/2022] [Accepted: 08/28/2022] [Indexed: 10/14/2022] Open
Abstract
Background To demonstrate the clinical usefulness of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computerized tomography (CT) for irreversible electroporation (IRE) in prostate cancer patients. Methods From January to May 2021, 17 men were diagnosed with localized prostate cancer through preoperative mpMRI and [18F] florastamin PSMA PET-CT imaging, followed by transperineal MRI-ultrasound fusion-guided biopsy. The patients underwent IRE focal therapy at the target lesions under general anesthesia. To evaluate the treatment outcome, serum prostate-specific antigen (PSA) levels were followed up in the 1st, 3rd, 6th, 9th, 12th months, and mpMRI was taken in the 1st and 12th months, followed by MR fusion biopsy in the 12th month post-IRE. Results The mean age of the patients was 66.1 ± 9.3 with a median PSA of 7.5 ng/ml. After the treatment, PSA nadir was 4.06 ± 3.4, and 11 (64.7%) achieved decline of PSA more than 50% from the baseline. Rate of negative biopsy for prostate cancer is 88% (15/17) at 12 months MR fusion biopsy after the IRE treatment. Among the relapsed cases, 1 (6.9%) patient recurred at margin of treated area, and 1 (6.9%) patient was from outfield recurrence. When excluding initial four patients, none of the patients had cancer recur. Conclusions When treating with IRE focal therapy, PSMA-PET CT is a potentially valuable diagnostic approach for localizing prostate cancer; it supports the detection of lesions with conventional mpMRI, enabling to perform the procedure more completely.
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Affiliation(s)
- Dongho Shin
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Eil Yoon
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeok Jae Kwon
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyong Woo Moon
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Hyun Park
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - U-Syn Ha
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sonya Youngju Park
- Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seunggyun Ha
- Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joo Hyun O
- Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ie Ryung Yoo
- Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chansoo Park
- Research Institute of Labelling, FutureChem Co., Ltd, Seoul, Korea
| | - Dae Yoon Chi
- Research Institute of Labelling, FutureChem Co., Ltd, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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The Role of [ 68Ga]PSMA PET/CT for Clinical Suspicion of Prostate Cancer in Patients with or without Previous Negative Biopsy: A Systematic Review. Cancers (Basel) 2022; 14:cancers14205036. [PMID: 36291820 PMCID: PMC9600353 DOI: 10.3390/cancers14205036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary In this paper we systematically evaluate the evidence regarding the role of [68Ga]PSMA PET/CT for clinical suspicions of prostate cancer in patients with or without previous negative biopsy. A critical review of PubMed and Web of Science according to the PRISMA statement was conducted. Eighteen publications were selected for inclusion in the analysis. In 8 articles, there was a direct comparison with mpMRI. [68Ga]PSMA PET/CT resulted more accurate in identifying primary prostate cancer with PSA values between 4 and 20 ng/mL than mpMRI. Moreover, its use combined with MRI improved sensitivity for csPCa detection, thus potentially avoiding unnecessary biopsies. Overall, [68Ga]PSMA PET/CT resulted a promising technique in patients with clinical suspicion of PCa and precedent negative biopsy or contraindications to MRI. Abstract The purpose of the study is to systematically evaluate the evidence regarding the role of [68Ga]PSMA PET/CT for clinical suspicions of prostate cancer in patients with or without previous negative biopsy. We performed a critical review of PubMed and Web of Science according to the PRISMA statement. Eighteen publications were selected for inclusion in this analysis. QUADAS-2 evaluation was adopted for quality analyses. [68Ga]PSMA-11 was the radiotracer of choice in 15 studies, while [68Ga]PSMA-617 was used in another 3. In 8 articles, there was a direct comparison with mpMRI. The total number of patients included was 1379, ranging from 15 to 291, with a median age of 64 years (range: 42–90). The median baseline PSA value was 12.9 ng/mL, ranging from 0.85 to 4156 ng/mL. Some studies evaluated the PSMA uptake comparing the SUVmax of suspicious lesions with the SUVmax of the normal biodistribution to find out optimal cut-off points. In addition, some studies suggested a significant association between PSA levels, PSA density, and [68Ga]PSMA PET/CT finding. [68Ga]PSMA PET/CT seems to be more accurate in identifying primary prostate cancer with PSA values between 4 and 20 ng/mL than mpMRI. Moreover, in some trials, the combination of PSMA PET/CT and MRI improved the NPV in the detection of clinically significant prostate cancer (csPCa) than MRI alone. Our findings are limited by the small numbers of studies and patient heterogeneity. [68Ga]PSMA PET/CT is a promising technique in patients with clinical suspicion of PCa and precedent negative biopsy or contraindications to MRI. Furthermore, its use combined with MRI improves sensitivity for csPCa detection and can avoid unnecessary biopsies.
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