Abstract
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Objectives: 68Ga-labelled prostate-specific membrane antigen ligand positron emission tomography/magnetic resonance imaging(PET/MRI) is being applied in clinical practice to assess the prostate cancer, particularly in patients with primary or biochemical recurrent prostate cancer. Our system review and meta-analysis is to evaluate the sensitivity, specificity and detection rate of 68Ga-PSMA PET/MRI in patients with primary prostate cancer(PCa) and biochemical recurrence(BCR).
Methods: We searched these literatures in PubMed, EMBASE and web of science until September 12, 2019. We included studies evaluating patients with primary PCa and BCR after previous treatment. The quality of each study was assessed using the quality assessment of diagnostic accuracy studies-2 tool, the pooled sensitivity(SEN), specificity(SPE) of PET/MRI in primary PC and the pooled detection rates of PET/MRI in BCR was conducted by using a random-effects model. Statistical heterogeneity was assessed by both the Cochran Q test and the I² statistic.
Results: thirteen studies involved 707 patients were included, the overall SEN and SPE in patients with primary PCa were 0.83 (95% CI, 0.73-0.90) and 0.81 (95% CI, 0.61-0.93), respectively (figure A). The AUC of PET/MRI was 0.89. For prostate cancer with BCR, the overall detection rate was 76%(95% CI, 72%-79%). According to the PSA categories 0-0.2, 0.2-1, 1-2 and >2 ng/ml, the pooled detection rates were 38%, 67%, 74%, 95%, respectively (figure B). There was no distinct public basis but significant study heterogeneity.
Conclusions: 68Ga-PSMA PET/MRI has favorable sensitivity and specificity profiles in diagnoses of patients with primary PCa. In addition, it also has high diagnostic accuracy in PCa with BCR. And the detection rates have positive correlation with PSA levels.