Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) has become an increasingly established imaging modality in the staging of prostate cancer (PCa).
Numerous PSMA-based tracers are currently available, however, there is a lack of consensus on the optimal radiotracer(s) for PSMA PET/CT. This study aims to investigate whether Fluorine-18 (18F)-labelled PSMA PET/CT is significantly different from Gallium-68 (68Ga) in primary diagnosis and/or secondary staging of prostate cancer following biochemical recurrence.
A critical review of MEDLINE, EMBASE, PubMed and Web of Science databases was performed in May 2023 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Studies that directly compared 18F-based PSMA radiotracers and [68Ga]Ga-PSMA-11 in terms of the normal organ SUV or the lesion SUV or the detection rate were assessed. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).
Twenty-four studies were analysed. [18F]DCFPyL and [18F]PSMA-1007 were the two most commonly studied 18F based PSMA tracers. [18F]JK-PSMA-7, [18F]rhPSMA-7, [18F]AlF-PSMA-11 were the new tracers evaluated in a limited number of studies. Overall, [18F]DCFPyL was observed to have a similar lesion detection rate to [68Ga]Ga-PSMA-11 with no increase in false positive rates. [18F]PSMA-1007 was found to have a greater local lesion detection rate because of its predominant hepatobiliary excretory route. However, [68Ga]Ga-PSMA-11 was observed to have a similar local lesion detection rate in studies that administer patients with furosemide prior to the scan. In addition, [18F]PSMA-1007 was found to have a significant number of benign bone uptakes.
[18F]DCFPyL was observed to be similar to [68Ga]Ga-PSMA-11. [18F]PSMA-1007 was observed to be less preferrable to [68Ga]Ga-PSMA-11 due to its high benign bone uptakes. Overall, there was not enough evidence in differentiating the radiotracers based on their clinical impacts.
Prostate cancer and prostatic diseases. 2023 Nov 28 [Epub ahead of print]
Siyu Huang, Sean Ong, Dean McKenzie, Adam Mirabelli, David C Chen, Thilakavathi Chengodu, Declan G Murphy, Michael S Hofman, Nathan Lawrentschuk, Marlon Perera
Department of Surgery, University of Melbourne, Parkville, VIC, Australia. ., Department of Surgery, University of Melbourne, Parkville, VIC, Australia., Research Development & Governance Unit, Epworth HealthCare, Melbourne, VIC, Australia., Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia., EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Melbourne, VIC, Australia., Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia., Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38017295