Abstract：
OBJECTIVE: To compare prostate-specific membrane antigen (PSMA) PET with multiparametric MRI (mpMRI) in the diagnosis of pretreatment prostate cancer (PCa).
METHODS: Pubmed, Embase, Medline, Web of Science, and Cochrane Library were searched for eligible studies published before June 22, 2022. We assessed risk of bias and applicability by using QUADAS-2 tool. Data synthesis was performed with Stata 17.0 software, using the \"midas\" and \"meqrlogit\" packages.
RESULTS: We included 29 articles focusing on primary cancer detection, 18 articles about primary staging, and two articles containing them both. For PSMA PET versus mpMRI in primary PCa detection, sensitivities and specificities in the per-patient analysis were 0.90 and 0.84 (p<0.0001), and 0.66 and 0.60 (p <0.0001), and in the per-lesion analysis they were 0.79 and 0.78 (p <0.0001), and 0.84 and 0.82 (p <0.0001). For the per-patient analysis of PSMA PET versus mpMRI in primary staging, sensitivities and specificities in extracapsular extension detection were 0.59 and 0.66 (p =0.005), and 0.79 and 0.76 (p =0.0074), and in seminal vesicle infiltration (SVI) detection they were 0.51 and 0.60 (p =0.0008), and 0.93 and 0.96 (p =0.0092). For PSMA PET versus mpMRI in lymph node metastasis (LNM) detection, sensitivities and specificities in the per-patient analysis were 0.68 and 0.46 (p <0.0001), and 0.91 and 0.90 (p =0.81), and in the per-lesion analysis they were 0.67 and 0.36 (p <0.0001), and 0.99 and 0.99 (p =0.18).
CONCLUSIONS: PSMA PET has higher diagnostic value than mpMRI in the detection of primary PCa. Regarding the primary staging, mpMRI has potential advantages in SVI detection, while PSMA PET has relative advantages in LNM detection.
CONCLUSIONS: The integration of prostate-specific membrane antigen (PSMA) PET into the diagnostic pathway may be helpful for improving the accuracy of prostate cancer detection. However, further studies are needed to address the cost implications and evaluate its utility in specific patient populations or clinical scenarios. Moreover, we recommend the combination of PSMA PET and mpMRI for cancer staging.
CONCLUSIONS: • Prostate-specific membrane antigen PET has higher sensitivity and specificity for primary tumor detection in prostate cancer compared to multiparametric MRI. • Prostate-specific membrane antigen PET also has significantly better sensitivity and specificity for lymph node metastases of prostate cancer compared to multiparametric MRI. • Multiparametric MRI has better accuracy for extracapsular extension and seminal vesicle infiltration compared to ate-specific membrane antigen PET.
METHODS: Pubmed, Embase, Medline, Web of Science, and Cochrane Library were searched for eligible studies published before June 22, 2022. We assessed risk of bias and applicability by using QUADAS-2 tool. Data synthesis was performed with Stata 17.0 software, using the \"midas\" and \"meqrlogit\" packages.
RESULTS: We included 29 articles focusing on primary cancer detection, 18 articles about primary staging, and two articles containing them both. For PSMA PET versus mpMRI in primary PCa detection, sensitivities and specificities in the per-patient analysis were 0.90 and 0.84 (p<0.0001), and 0.66 and 0.60 (p <0.0001), and in the per-lesion analysis they were 0.79 and 0.78 (p <0.0001), and 0.84 and 0.82 (p <0.0001). For the per-patient analysis of PSMA PET versus mpMRI in primary staging, sensitivities and specificities in extracapsular extension detection were 0.59 and 0.66 (p =0.005), and 0.79 and 0.76 (p =0.0074), and in seminal vesicle infiltration (SVI) detection they were 0.51 and 0.60 (p =0.0008), and 0.93 and 0.96 (p =0.0092). For PSMA PET versus mpMRI in lymph node metastasis (LNM) detection, sensitivities and specificities in the per-patient analysis were 0.68 and 0.46 (p <0.0001), and 0.91 and 0.90 (p =0.81), and in the per-lesion analysis they were 0.67 and 0.36 (p <0.0001), and 0.99 and 0.99 (p =0.18).
CONCLUSIONS: PSMA PET has higher diagnostic value than mpMRI in the detection of primary PCa. Regarding the primary staging, mpMRI has potential advantages in SVI detection, while PSMA PET has relative advantages in LNM detection.
CONCLUSIONS: The integration of prostate-specific membrane antigen (PSMA) PET into the diagnostic pathway may be helpful for improving the accuracy of prostate cancer detection. However, further studies are needed to address the cost implications and evaluate its utility in specific patient populations or clinical scenarios. Moreover, we recommend the combination of PSMA PET and mpMRI for cancer staging.
CONCLUSIONS: • Prostate-specific membrane antigen PET has higher sensitivity and specificity for primary tumor detection in prostate cancer compared to multiparametric MRI. • Prostate-specific membrane antigen PET also has significantly better sensitivity and specificity for lymph node metastases of prostate cancer compared to multiparametric MRI. • Multiparametric MRI has better accuracy for extracapsular extension and seminal vesicle infiltration compared to ate-specific membrane antigen PET.
摘要：
目的：比较前列腺特异性膜抗原（PSMA）PET与多参数MRI（mpMRI）在预处理前列腺癌（PCa）诊断中的价值。
方法：发布，Embase,Medline,WebofScience,和Cochrane图书馆被搜索2022年6月22日前发表的符合条件的研究。我们使用QUADAS-2工具评估了偏倚和适用性的风险。数据综合采用Stata17.0软件,使用\"midas\"和\"meqrlogit\"包。
结果：我们收录了29篇关注原发癌检测的文章，18篇关于初级分期的文章，和两篇文章都包含它们。对于PSMAPET与MPMRI在原发性PCa检测中的比较，每个患者分析的敏感性和特异性分别为0.90和0.84(p<0.0001)，0.66和0.60（p<0.0001），在每个病变分析中，它们分别为0.79和0.78(p<0.0001)，和0.84和0.82（p<0.0001）。对于PSMAPET与mpMRI在原发性分期中的每位患者分析，囊外延伸检测的敏感性和特异性分别为0.59和0.66(p=0.005)，和0.79和0.76（p=0.0074），在精囊浸润（SVI）检测中，它们分别为0.51和0.60（p=0.0008），0.93和0.96(p=0.0092)。对于淋巴结转移（LNM）检测中的PSMAPET与mpMRI，每个患者分析的敏感性和特异性分别为0.68和0.46(p<0.0001)，0.91和0.90(p=0.81)，在每个病变分析中，它们分别为0.67和0.36(p<0.0001)，0.99和0.99（p=0.18）。
结论：PSMAPET对原发性PCa的诊断价值高于mpMRI。关于初级分期，MPMRI在SVI检测中具有潜在的优势，而PSMAPET在LNM检测中具有相对优势。
结论：将前列腺特异性膜抗原（PSMA）PET整合到诊断途径中可能有助于提高前列腺癌检测的准确性。然而,需要进一步的研究来解决成本影响,并评估其在特定患者群体或临床情景中的效用.此外，我们推荐PSMAPET和mpMRI联合用于癌症分期.
结论：•与多参数MRI相比，前列腺特异性膜抗原PET对前列腺癌原发肿瘤检测具有更高的敏感性和特异性。•与多参数MRI相比,前列腺特异性膜抗原PET对前列腺癌的淋巴结转移也具有显著更好的敏感性和特异性。•与特定膜抗原PET相比，多参数MRI对于囊外延伸和精囊浸润具有更好的准确性。
方法：发布，Embase,Medline,WebofScience,和Cochrane图书馆被搜索2022年6月22日前发表的符合条件的研究。我们使用QUADAS-2工具评估了偏倚和适用性的风险。数据综合采用Stata17.0软件,使用\"midas\"和\"meqrlogit\"包。
结果：我们收录了29篇关注原发癌检测的文章，18篇关于初级分期的文章，和两篇文章都包含它们。对于PSMAPET与MPMRI在原发性PCa检测中的比较，每个患者分析的敏感性和特异性分别为0.90和0.84(p<0.0001)，0.66和0.60（p<0.0001），在每个病变分析中，它们分别为0.79和0.78(p<0.0001)，和0.84和0.82（p<0.0001）。对于PSMAPET与mpMRI在原发性分期中的每位患者分析，囊外延伸检测的敏感性和特异性分别为0.59和0.66(p=0.005)，和0.79和0.76（p=0.0074），在精囊浸润（SVI）检测中，它们分别为0.51和0.60（p=0.0008），0.93和0.96(p=0.0092)。对于淋巴结转移（LNM）检测中的PSMAPET与mpMRI，每个患者分析的敏感性和特异性分别为0.68和0.46(p<0.0001)，0.91和0.90(p=0.81)，在每个病变分析中，它们分别为0.67和0.36(p<0.0001)，0.99和0.99（p=0.18）。
结论：PSMAPET对原发性PCa的诊断价值高于mpMRI。关于初级分期，MPMRI在SVI检测中具有潜在的优势，而PSMAPET在LNM检测中具有相对优势。
结论：将前列腺特异性膜抗原（PSMA）PET整合到诊断途径中可能有助于提高前列腺癌检测的准确性。然而,需要进一步的研究来解决成本影响,并评估其在特定患者群体或临床情景中的效用.此外，我们推荐PSMAPET和mpMRI联合用于癌症分期.
结论：•与多参数MRI相比，前列腺特异性膜抗原PET对前列腺癌原发肿瘤检测具有更高的敏感性和特异性。•与多参数MRI相比,前列腺特异性膜抗原PET对前列腺癌的淋巴结转移也具有显著更好的敏感性和特异性。•与特定膜抗原PET相比，多参数MRI对于囊外延伸和精囊浸润具有更好的准确性。
