Comparison of 18F-based PSMA radiotracers with [68Ga]Ga-PSMA-11 in PET/CT imaging of prostate cancer—a systematic review and meta-analysis,Prostate Cancer and Prostatic Diseases

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Comparison of 18F-based PSMA radiotracers with [68Ga]Ga-PSMA-11 in PET/CT imaging of prostate cancer—a systematic review and meta-analysis
Prostate Cancer and Prostatic Diseases ( IF 4.8 ) Pub Date : 2023-11-28 , DOI: 10.1038/s41391-023-00755-2
Siyu Huang ₁ , Sean Ong _{1,

2} , Dean McKenzie _{3,

4} , Adam Mirabelli ₁ , David C Chen _{5,

6,

7} , Thilakavathi Chengodu ₂ , Declan G Murphy _{6,

8} , Michael S Hofman _{5,

6} , Nathan Lawrentschuk _{1,

2,

9} , Marlon Perera _{8,

10}

Affiliation

Department of Surgery, University of Melbourne, Parkville, VIC, Australia.
EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Melbourne, VIC, Australia.
Research Development & Governance Unit, Epworth HealthCare, Melbourne, VIC, Australia.
Department of Health Science and Biostatistics, Swinburne University of Technology, Melbourne, VIC, Australia.
Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
Young Urology Researchers Organisation (YURO), Melbourne, VIC, Australia.
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Department of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia.
Department of Surgery, Austin Health, The University of Melbourne, Melbourne, VIC, Australia.

Background

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.

Methods

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).

Results

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.

Conclusions

[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.

中文翻译：

基于 18F 的 PSMA 放射性示踪剂与 [68Ga]Ga-PSMA-11 在前列腺癌 PET/CT 成像中的比较——系统评价和荟萃分析

背景

前列腺特异性膜抗原 (PSMA) 正电子发射断层扫描 (PET)/计算机断层扫描 (CT) 已成为前列腺癌 (PCa) 分期中日益成熟的成像方式。目前有许多基于 PSMA 的示踪剂可用，但是，对于 PSMA PET/CT 的最佳放射性示踪剂缺乏共识。本研究旨在探讨氟 18 ( ¹⁸ F) 标记的 PSMA PET/CT在前列腺癌生化复发后的初步诊断和/或二次分期中是否与镓 68 ( ⁶⁸ Ga)显着不同。

方法

根据系统审查和荟萃分析的首选报告项目 (PRISMA) 声明，于 2023 年 5 月对 MEDLINE、EMBASE、PubMed 和 Web of Science 数据库进行了严格审查。评估了直接比较¹⁸ F基PSMA放射性示踪剂和[ ⁶⁸ Ga]Ga-PSMA-11在正常器官SUV或病变SUV或检出率方面的研究。使用诊断准确性研究质量评估-2 (QUADAS-2) 评估质量。

结果

分析了二十四项研究。[ ¹⁸ F]DCFPyL 和[ ¹⁸ F]PSMA-1007 是两种最常研究的基于¹⁸ F 的 PSMA 示踪剂。[ ¹⁸ F]JK-PSMA-7、[ ¹⁸ F]rhPSMA-7、[ ¹⁸ F]AlF-PSMA-11 是在有限数量的研究中评估的新示踪剂。总体而言，观察到[ ¹⁸ F]DCFPyL 具有与[ ⁶⁸ Ga]Ga-PSMA-11 相似的病变检出率，且假阳性率没有增加。[ ¹⁸ F]PSMA-1007因其主要的肝胆排泄途径而具有较高的局部病变检出率。然而，在扫描前给予患者呋塞米的研究中观察到[ ^{68 Ga]Ga-PSMA-11 具有相似的局部病变检出率。}此外，[ ¹⁸ F]PSMA-1007被发现具有大量良性骨摄取。