Instituto do Cérebro do Rio Grande do Sul, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brasil.
Laboratório de Imagens Médicas, Faculdade de Ciências, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brasil.
Int Braz J Urol. 2021 Jul-Aug;47(4):705-729. doi: 10.1590/S1677-5538.IBJU.2019.0817.
Prostate cancer (PC) is the second most commonly diagnosed cancer in males. 68Ga-PSMA PET/CT, a non-invasive diagnostic tool to evaluate PC with prostate-specific membrane antigen (PSMA) expression, has emerged as a more accurate alternative to assess disease staging. We aimed to identify predictors of positive 68Ga-PSMA PET and the accuracy of this technique.
Diagnostic accuracy cross-sectional study with prospective and retrospective approaches. We performed a comprehensive literature search on PubMed, Cochrane Library, and Embase database in search of studies including PC patients submitted to radical prostatectomy or radiotherapy with curative intent and presented biochemical recurrence following ASTRO 1996 criteria. A total of 35 studies involving 3910 patients submitted to 68-Ga-PSMA PET were included and independently assessed by two authors: 8 studies on diagnosis, four on staging, and 23 studies on restaging purposes. The significance level was α=0.05.
pooled sensitivity and specificity were 0.90 (0.86-0.93) and 0.90 (0.82-0.96), respectively, for diagnostic purposes; as for staging, pooled sensitivity and specificity were 0.93 (0.86-0.98) and 0.96 (0.92-0.99), respectively. In the restaging scenario, pooled sensitivity and specificity were 0.76 (0.74-0.78) and 0.45 (0.27-0.58), respectively, considering the identification of prostate cancer in each described situation. We also obtained specificity and sensitivity results for PSA subdivisions.
68Ga-PSMA PET provides higher sensitivity and specificity than traditional imaging for prostate cancer.
前列腺癌（PC）是男性中第二大常见的癌症。68Ga-PSMA PET/CT 是一种评估前列腺特异性膜抗原（PSMA）表达的非侵入性诊断工具，已成为评估疾病分期的更准确替代方法。我们旨在确定 68Ga-PSMA PET 阳性的预测因素及其准确性。
采用前瞻性和回顾性方法进行诊断准确性的横断面研究。我们在 PubMed、Cochrane Library 和 Embase 数据库上进行了全面的文献检索，以寻找包括接受根治性前列腺切除术或有治愈意图的放疗并根据 ASTRO 1996 标准出现生化复发的 PC 患者的研究。共纳入了 35 项涉及 3910 例患者的 68-Ga-PSMA PET 的研究，并由两名作者独立评估：8 项关于诊断的研究，4 项关于分期的研究，23 项关于重新分期的研究。显著性水平为 α=0.05。
诊断目的的汇总敏感性和特异性分别为 0.90（0.86-0.93）和 0.90（0.82-0.96）；对于分期，汇总敏感性和特异性分别为 0.93（0.86-0.98）和 0.96（0.92-0.99）。在重新分期情况下，考虑到在每种描述的情况下识别前列腺癌，汇总敏感性和特异性分别为 0.76（0.74-0.78）和 0.45（0.27-0.58）。我们还获得了 PSA 细分的特异性和敏感性结果。
68Ga-PSMA PET 为前列腺癌提供了比传统成像更高的敏感性和特异性。
