TY - JOUR
T1 - 18F-Fluciclovine versus PSMA PET Imaging in Primary Tumor Detection during Initial Staging of High-Risk Prostate Cancer
T2 - A Systematic Review and Meta-Analysis
AU - Yadav, Divya
AU - Hwang, Hyunsoo
AU - Qiao, Wei
AU - Upadhyay, Rituraj
AU - Chapin, Brian F.
AU - Tang, Chad
AU - Aparicio, Ana
AU - Lopez-Olivo, Maria A.
AU - Kang, Stella K.
AU - Macapinlac, Homer A.
AU - Bathala, Tharakeswara K.
AU - Surasi, Devaki Shilpa
N1 - Publisher Copyright:
© RSNA, 2022.
PY - 2022/3
Y1 - 2022/3
N2 - Purpose: Fluorine 18 (18F)-fluciclovine and prostate-specific membrane antigen (PSMA) tracers are commonly used for localizing biochemical recurrence of prostate cancer, but their accuracy in primary tumor detection in the initial staging of high-risk prostate cancer has not been established. Materials and Methods: A systematic review was performed of the electronic databases for original studies published between 2012 and 2020. Included studies were those in which 18F-fluciclovine or PSMA PET was used for initial staging of patients with high-risk prostate cancer. The diagnostic performance data were collected for primary tumor with histopathologic results as reference standard. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used for quality appraisal. A random-effects model was used to summarize the effect sizes and to evaluate the difference between two groups. Results: Overall, 28 studies met the eligibility criteria, and 17 were included in the meta-analysis (18F-fluciclovine=4, PSMA=13). Of these 17 studies, 12 (70%) were judged to have high risk of bias in one of the evaluated domains, and nine studies were deemed to have applicability concerns. The pooled sensitivity, specificity, and diagnostic odds ratio for 18F-fluciclovine versus PSMA were 85% (95% CI: 73%, 92%) versus 84% (95% CI: 77%, 89%) (P=.78), 77% (95% CI: 60%, 88%) versus 83% (95% CI: 76%, 89%) (P=.40), and 18.88 (95% CI: 5.01, 71.20) versus 29.37 (95% CI: 13.35, 64.60) (P=.57), respectively, with no significant difference in diagnostic test accuracy. Conclusion:18F-fluciclovine and PSMA PET demonstrated no statistically significant difference in diagnostic accuracy in primary tumor detection during initial staging of high-risk prostate cancer.
AB - Purpose: Fluorine 18 (18F)-fluciclovine and prostate-specific membrane antigen (PSMA) tracers are commonly used for localizing biochemical recurrence of prostate cancer, but their accuracy in primary tumor detection in the initial staging of high-risk prostate cancer has not been established. Materials and Methods: A systematic review was performed of the electronic databases for original studies published between 2012 and 2020. Included studies were those in which 18F-fluciclovine or PSMA PET was used for initial staging of patients with high-risk prostate cancer. The diagnostic performance data were collected for primary tumor with histopathologic results as reference standard. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used for quality appraisal. A random-effects model was used to summarize the effect sizes and to evaluate the difference between two groups. Results: Overall, 28 studies met the eligibility criteria, and 17 were included in the meta-analysis (18F-fluciclovine=4, PSMA=13). Of these 17 studies, 12 (70%) were judged to have high risk of bias in one of the evaluated domains, and nine studies were deemed to have applicability concerns. The pooled sensitivity, specificity, and diagnostic odds ratio for 18F-fluciclovine versus PSMA were 85% (95% CI: 73%, 92%) versus 84% (95% CI: 77%, 89%) (P=.78), 77% (95% CI: 60%, 88%) versus 83% (95% CI: 76%, 89%) (P=.40), and 18.88 (95% CI: 5.01, 71.20) versus 29.37 (95% CI: 13.35, 64.60) (P=.57), respectively, with no significant difference in diagnostic test accuracy. Conclusion:18F-fluciclovine and PSMA PET demonstrated no statistically significant difference in diagnostic accuracy in primary tumor detection during initial staging of high-risk prostate cancer.
KW - Molecular Imaging–Cancer
KW - PET
KW - Prostate
KW - Staging
UR - http://www.scopus.com/inward/record.url?scp=85125550650&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85125550650&partnerID=8YFLogxK
U2 - 10.1148/rycan.210091
DO - 10.1148/rycan.210091
M3 - Article
C2 - 35212559
AN - SCOPUS:85125550650
SN - 2638-616X
VL - 4
JO - Radiology: Imaging Cancer
JF - Radiology: Imaging Cancer
IS - 2
M1 - e210091
ER -