Detection rates of recurrent prostate cancer: 68Gallium (Ga)-labelled prostate-specific membrane antigen versus choline PET/CT scans. A systematic review
Detection rates of recurrent prostate cancer: 68Gallium (Ga)-labelled prostate-specific membrane antigen versus choline PET/CT scans. A systematic review
Background: The aim of this work was to assess the use of prostate-specific membrane antigen (PSMA)-labelled radiotracers in detecting the recurrence of prostate cancer. PSMA is thought to have higher detection rates when utilized in positron emission tomography (PET)/computed tomography (CT) scans, particularly at lower prostate-specific antigen (PSA) levels, compared with choline-based scans.
Methods: A systematic review was conducted comparing choline and PSMA PET/CT scans in patients with recurrent prostate cancer following an initial curative attempt. The primary outcomes were overall detection rates, detection rates at low PSA thresholds, difference in detection rates and exclusive detection rates on a per-person analysis. Secondary outcome measures were total number of lesions, exclusive detection by each scan on a per-lesion basis and adverse side effects.
Results: Overall detection rates were 79.8% for PSMA and 66.7% for choline. There was a statistically significant difference in detection rates favouring PSMA [OR (M-H, random, 95% confidence interval (CI)) 2.27 (1.06, 4.85), p = 0.04]. Direct comparison was limited to PSA < 2 ng/ml in two studies, with no statistically significant difference in detection rates between the scans [OR (M-H, random, 95% CI) 2.37 (0.61, 9.17) p = 0.21]. The difference in detection on the per-patient analysis was significantly higher in the PSMA scans (p < 0.00001). All three studies reported higher lymph node, bone metastasis and locoregional recurrence rates in PSMA.
Conclusions: PSMA PET/CT has a better performance compared with choline PET/CT in detecting recurrent disease both on per-patient and per-lesion analysis and should be the imaging modality of choice while deciding on salvage and nonsystematic metastasis-directed therapy strategies.
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Moghul, Masood
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Somani, Bhaskar
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Lane, Tim
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Vasdev, Nikhil
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Chaplin, Brian
34e31cc7-8f24-43a3-89da-a137dd398471
Peedell, Clive
1a5a18a2-8601-4cee-a12b-3f2bfa75f81e
KandaSwamy, Gokul Vignesh
c143aa59-0911-48cb-8173-943d68647b8e
Rai, Bhavan Prasad
e1156207-bfd1-4f89-b0aa-9e55fc54235b
24 January 2019
Moghul, Masood
4abd0494-f47e-4d4a-acfe-7130d583e430
Somani, Bhaskar
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Lane, Tim
91a527f4-1b81-47a6-bd89-118249142bc2
Vasdev, Nikhil
8afb2cff-f10e-4fae-86c0-6d5624ed8cec
Chaplin, Brian
34e31cc7-8f24-43a3-89da-a137dd398471
Peedell, Clive
1a5a18a2-8601-4cee-a12b-3f2bfa75f81e
KandaSwamy, Gokul Vignesh
c143aa59-0911-48cb-8173-943d68647b8e
Rai, Bhavan Prasad
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Moghul, Masood, Somani, Bhaskar, Lane, Tim, Vasdev, Nikhil, Chaplin, Brian, Peedell, Clive, KandaSwamy, Gokul Vignesh and Rai, Bhavan Prasad
(2019)
Detection rates of recurrent prostate cancer: 68Gallium (Ga)-labelled prostate-specific membrane antigen versus choline PET/CT scans. A systematic review.
Therapeutic Advances in Urology, 11, .
(doi:10.1177/1756287218815793).
Abstract
Background: The aim of this work was to assess the use of prostate-specific membrane antigen (PSMA)-labelled radiotracers in detecting the recurrence of prostate cancer. PSMA is thought to have higher detection rates when utilized in positron emission tomography (PET)/computed tomography (CT) scans, particularly at lower prostate-specific antigen (PSA) levels, compared with choline-based scans.
Methods: A systematic review was conducted comparing choline and PSMA PET/CT scans in patients with recurrent prostate cancer following an initial curative attempt. The primary outcomes were overall detection rates, detection rates at low PSA thresholds, difference in detection rates and exclusive detection rates on a per-person analysis. Secondary outcome measures were total number of lesions, exclusive detection by each scan on a per-lesion basis and adverse side effects.
Results: Overall detection rates were 79.8% for PSMA and 66.7% for choline. There was a statistically significant difference in detection rates favouring PSMA [OR (M-H, random, 95% confidence interval (CI)) 2.27 (1.06, 4.85), p = 0.04]. Direct comparison was limited to PSA < 2 ng/ml in two studies, with no statistically significant difference in detection rates between the scans [OR (M-H, random, 95% CI) 2.37 (0.61, 9.17) p = 0.21]. The difference in detection on the per-patient analysis was significantly higher in the PSMA scans (p < 0.00001). All three studies reported higher lymph node, bone metastasis and locoregional recurrence rates in PSMA.
Conclusions: PSMA PET/CT has a better performance compared with choline PET/CT in detecting recurrent disease both on per-patient and per-lesion analysis and should be the imaging modality of choice while deciding on salvage and nonsystematic metastasis-directed therapy strategies.
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1756287218815793
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Accepted/In Press date: 6 November 2018
e-pub ahead of print date: 8 January 2019
Published date: 24 January 2019
Identifiers
Local EPrints ID: 433456
URI: http://eprints.soton.ac.uk/id/eprint/433456
ISSN: 1756-2872
PURE UUID: 9f5d5e33-b875-4cc5-850d-772c35c7288d
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Date deposited: 22 Aug 2019 16:30
Last modified: 16 Mar 2024 03:24
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Contributors
Author:
Masood Moghul
Author:
Tim Lane
Author:
Nikhil Vasdev
Author:
Brian Chaplin
Author:
Clive Peedell
Author:
Gokul Vignesh KandaSwamy
Author:
Bhavan Prasad Rai
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