比较放射性示踪剂在前列腺癌生化复发中的诊断性能：系统评价和荟萃分析。
Comparing the diagnostic performance of radiotracers in prostate cancer biochemical recurrence: a systematic review and meta-analysis.
机构信息
Department of Radiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing, 312000, China.
Department of Radiotherapy, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, 312000, China.
出版信息
Eur Radiol. 2022 Nov;32(11):7374-7385. doi: 10.1007/s00330-022-08802-7. Epub 2022 Apr 29.
OBJECTIVES
To systematically assess the early detection rate of biochemical prostate cancer recurrence using choline, fluciclovine, and PSMA.
METHODS
Under the guidance of the Preferred Reporting Items for Systematic reviews and Meta-Analysis Diagnostic Test Accuracy guidelines, literature that assessed the detection rates (DRs) of choline, fluciclovine, and PSMA in prostate cancer biochemical recurrence was searched in PubMed and EMBASE databases for our systematic review from 2012 to July 15, 2021. In addition, the PSA-stratified performance of detection positivity was obtained to assess the DRs for various methods, including fluciclovine, PSMA, or choline PET/CT, with respect to biochemical recurrence based on different PSA levels.
RESULTS
In total, 64 studies involving 11,173 patients met the inclusion criteria. Of the studies, 12, 7, and 48 focused on choline, fluciclovine, and PSMA, respectively. The pooled DRs were 24%, 37%, and 44%, respectively, for a PSA level less than 0.5 ng/mL (p < 0.001); 36%, 44%, and 60% for a PSA level of 0.5-0.99 ng/mL (p < 0.001); and 50%, 61%, and 80% for a PSA level of 1.0-1.99 ng/mL (p < 0.001). The DR with F-labeled PSMA was higher than that with Ga-labeled PSMA, and the DR was 58%, 72%, and 88% for PSA levels < 0.5 ng/mL, 0.5-0.9 ng/mL, and 1.0-1.99 ng/mL, respectively.
CONCLUSION
The DRs of PSMA-radiotracers were greater than those of choline-radiotracers and fluciclovine-radiotracers at the patient level. F-labeled PSMA achieved a higher DR than Ga-labeled PSMA.
KEY POINTS
• The DRs of PSMA-radiotracers were greater than those of choline-radiotracers and fluciclovine-radiotracers at the patient level. • F-labeled PSMA achieved a higher DR than Ga-labeled PSMA.
目的
系统评估胆碱、氟尿嘧啶和 PSMA 对生化前列腺癌复发的早期检测率。
方法
根据系统评价和荟萃分析诊断测试准确性报告的首选项目指南，从 2012 年至 2021 年 7 月 15 日，在 PubMed 和 EMBASE 数据库中搜索评估前列腺癌生化复发中胆碱、氟尿嘧啶和 PSMA 检测率（DR）的文献，进行本系统评价。此外，还获得了 PSA 分层检测阳性率，以评估基于不同 PSA 水平的各种方法（包括氟尿嘧啶、PSMA 或胆碱 PET/CT）对生化复发的检测阳性率。
结果
共有 64 项研究纳入了 11173 名患者。其中，12 项、7 项和 48 项分别专注于胆碱、氟尿嘧啶和 PSMA。PSA 水平<0.5ng/ml 时，汇总的 DR 分别为 24%、37%和 44%（p<0.001）；PSA 水平为 0.5-0.99ng/ml 时，分别为 36%、44%和 60%（p<0.001）；PSA 水平为 1.0-1.99ng/ml 时，分别为 50%、61%和 80%（p<0.001）。F-标记 PSMA 的 DR 高于 Ga-标记 PSMA，PSA 水平<0.5ng/ml、0.5-0.9ng/ml 和 1.0-1.99ng/ml 时，DR 分别为 58%、72%和 88%。
结论
在患者水平上，PSMA 放射性示踪剂的 DR 高于胆碱放射性示踪剂和氟尿嘧啶放射性示踪剂。F-标记 PSMA 的 DR 高于 Ga-标记 PSMA。
关键点
在患者水平上，PSMA 放射性示踪剂的 DR 高于胆碱放射性示踪剂和氟尿嘧啶放射性示踪剂。
F-标记 PSMA 的 DR 高于 Ga-标记 PSMA。
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