Diagnostic Accuracy of 18F-Prostate Specific Membrane Antigen (PSMA) PET/CT Radiotracers in Staging and Restaging of Patients With High-Risk Prostate Cancer or Biochemical Recurrence: An Overview of Reviews.

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Seminars in nuclear medicine Pub Date : 2024-06-20 DOI:10.1053/j.semnuclmed.2024.05.003
Andrew Dullea, Lydia O'Sullivan, Kirsty K O'Brien, Marie Carrigan, Susan Ahern, Maeve McGarry, Patricia Harrington, Kieran A Walsh, Susan M Smith, Máirín Ryan
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Abstract

The aim of this overview was to consolidate existing evidence syntheses and provide a comprehensive overview of the evidence for 18F-prostate specific membrane antigen (PSMA) PET/CT in the staging of high-risk prostate cancer and restaging after biochemical recurrence. An overview of reviews was performed and reported in line with the preferred reporting items for overview of reviews (PRIOR) statement and synthesis without meta-analysis (SWiM) reporting guidelines. A comprehensive database and grey literature search were conducted up to July 18, 2023. Systematic reviews were assessed using the risk of bias in systematic reviews (ROBIS) tool. The certainty of the evidence was assessed using grading of recommendations, assessment, development and evaluations (GRADE). 11 systematic reviews were identified; 10 were at high or unclear risk of bias. Evidence reported on a per-patient, per-lymph node, and per-lesion basis for sensitivity, specificity and overall accuracy was identified. There was a lack of data on dose, adverse events and evidence directly comparing 18F-PSMA PET/CT to other imaging modalities. Evidence with moderate to very low certainty indicated high sensitivity, specificity and accuracy of 18F-PSMA PET/CT in patients with high-risk prostate cancer and biochemical recurrence. There was considerably lower certainty evidence and greater variability in effect estimates for outcomes for the combined intermediate/high-risk cohort. While evidence gaps remain for some outcomes, and most systematic reviews were at high or unclear risk of bias, the current evidence base is broadly supportive of 18F-PSMA PET/CT imaging in the staging and restaging of patients with high-risk prostate cancer and biochemical recurrence.

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18F-前列腺特异性膜抗原(PSMA)PET/CT 放射性标记物在高危前列腺癌或生化复发患者的分期和再分期中的诊断准确性:综述。
本综述旨在整合现有的证据综述,全面概述18F-前列腺特异性膜抗原(PSMA)PET/CT用于高危前列腺癌分期和生化复发后重新分期的证据。根据综述首选报告项目(PRIOR)声明和无荟萃分析综合(SWiM)报告指南进行了综述报告。截至 2023 年 7 月 18 日,我们进行了全面的数据库和灰色文献检索。系统性综述采用系统性综述偏倚风险(ROBIS)工具进行评估。使用建议、评估、发展和评价分级(GRADE)对证据的确定性进行评估。共确定了 11 篇系统性综述,其中 10 篇存在较高或不明确的偏倚风险。根据每位患者、每个淋巴结和每个病灶的敏感性、特异性和总体准确性,确定了报告的证据。缺乏有关剂量、不良事件的数据,也缺乏直接比较18F-PSMA PET/CT与其他成像方式的证据。中度至极度不确定的证据表明,18F-PSMA PET/CT 对高危前列腺癌和生化复发患者具有较高的灵敏度、特异性和准确性。对于中/高风险合并队列的结果,证据的确定性要低得多,效应估计值的变异性也更大。虽然某些结果仍存在证据缺口,而且大多数系统性综述的偏倚风险较高或不明确,但目前的证据基础广泛支持18F-PSMA PET/CT成像对高危前列腺癌和生化复发患者进行分期和重新分期。
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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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