Wang Rang, Shen Guohua, Huang Mingxing, Tian Rong
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2021 Jun 17;11:684629. doi: 10.3389/fonc.2021.684629. eCollection 2021.
Diagnosing the biochemical recurrence (BCR) of prostate cancer (PCa) is a clinical challenge, and early detection of BCR can help patients receive optimal treatment. We conducted a meta-analysis to define the diagnostic accuracy of PET/CT using F-labeled choline, fluciclovine, and prostate-specific membrane antigen (PSMA) in patients with BCR.
Multiple databases were searched until March 30, 2021. We included studies investigating the diagnostic accuracy of F-choline, F-fluciclovine, and F-PSMA PET/CT in patients with BCR. The pooled sensitivity, specificity, and detection rate of F-labeled tracers were calculated with a random-effects model.
A total of 46 studies met the included criteria; 17, 16, and 13 studies focused on F-choline, fluciclovine, and PSMA, respectively. The pooled sensitivities of F-choline and F-fluciclovine were 0.93 (95% CI, 0.85-0.98) and 0.80 (95% CI, 0.65-0.897), and the specificities were 0.91 (95% CI, 0.73-0.97) and 0.66 (95% CI, 0.50-0.79), respectively. The pooled detection rates of F-labeled choline, fluciclovine and PSMA were 66, 74, and 83%, respectively. Moreover, the detection rates of F-labeled choline, fluciclovine, and PSMA were 35, 23, and 58% for a PSA level less than 0.5 ng/ml; 41, 46, and 75% for a PSA level of 0.5-0.99 ng/ml; 62, 57, and 86% for a PSA level of 1.0-1.99 ng/ml; 80, 92, and 94% for a PSA level more than 2.0 ng/ml.
These three F-labeled tracers are promising for detecting BCR in prostate cancer patients, with F-choline showing superior diagnostic accuracy. In addition, the much higher detection rates of F-PSMA showed its superiority over other tracers, particularly in low PSA levels.
PROSPERO, identifier CRD42020212531.
诊断前列腺癌（PCa）的生化复发（BCR）是一项临床挑战，早期检测BCR有助于患者接受最佳治疗。我们进行了一项荟萃分析，以确定使用F标记的胆碱、氟代脱氧葡萄糖和前列腺特异性膜抗原（PSMA）的PET/CT在BCR患者中的诊断准确性。
检索多个数据库至2021年3月30日。我们纳入了研究F-胆碱、F-氟代脱氧葡萄糖和F-PSMA PET/CT在BCR患者中诊断准确性的研究。采用随机效应模型计算F标记示踪剂的合并敏感性、特异性和检出率。
共有46项研究符合纳入标准；分别有17、16和13项研究聚焦于F-胆碱、氟代脱氧葡萄糖和PSMA。F-胆碱和F-氟代脱氧葡萄糖的合并敏感性分别为0.93（95%CI，0.85-0.98）和0.80（95%CI，0.65-0.897），特异性分别为0.91（95%CI，0.73-0.97）和0.66（95%CI，0.50-0.79）。F标记的胆碱、氟代脱氧葡萄糖和PSMA的合并检出率分别为66%、74%和83%。此外，对于PSA水平低于0.5 ng/ml，F标记的胆碱、氟代脱氧葡萄糖和PSMA的检出率分别为35%、23%和58%；对于PSA水平为0.5-0.99 ng/ml，分别为41%、46%和75%；对于PSA水平为1.0-1.99 ng/ml，分别为62%、57%和86%；对于PSA水平高于2.0 ng/ml，分别为80%、92%和94%。
这三种F标记示踪剂在检测前列腺癌患者的BCR方面很有前景，F-胆碱显示出更高的诊断准确性。此外，F-PSMA更高的检出率显示出其优于其他示踪剂，尤其是在低PSA水平时。
PROSPERO，标识符CRD42020212531。
