Your browser doesn't support javascript.
loading
Comparing the diagnostic performance of radiotracers in recurrent prostate cancer: a systematic review and network meta-analysis.
Alberts, Ian Leigh; Seide, Svenja Elizabeth; Mingels, Clemens; Bohn, Karl Peter; Shi, Kuangyu; Zacho, Helle D; Rominger, Axel; Afshar-Oromieh, Ali.
Afiliação
  • Alberts IL; Department of Nuclear Medicine. Inselspital, Bern University Hospital, University of Bern, Street: Freiburgstr. 18, CH-3010, Bern, Switzerland. ian.alberts@insel.ch.
  • Seide SE; Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
  • Mingels C; Department of Nuclear Medicine. Inselspital, Bern University Hospital, University of Bern, Street: Freiburgstr. 18, CH-3010, Bern, Switzerland.
  • Bohn KP; Department of Nuclear Medicine. Inselspital, Bern University Hospital, University of Bern, Street: Freiburgstr. 18, CH-3010, Bern, Switzerland.
  • Shi K; Department of Nuclear Medicine. Inselspital, Bern University Hospital, University of Bern, Street: Freiburgstr. 18, CH-3010, Bern, Switzerland.
  • Zacho HD; Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, DK-9000, Aalborg, Denmark.
  • Rominger A; Department of Nuclear Medicine. Inselspital, Bern University Hospital, University of Bern, Street: Freiburgstr. 18, CH-3010, Bern, Switzerland.
  • Afshar-Oromieh A; Department of Nuclear Medicine. Inselspital, Bern University Hospital, University of Bern, Street: Freiburgstr. 18, CH-3010, Bern, Switzerland.
Eur J Nucl Med Mol Imaging ; 48(9): 2978-2989, 2021 08.
Article em En | MEDLINE | ID: mdl-33550425
ABSTRACT

PURPOSE:

Many radiotracers are currently available for the detection of recurrent prostate cancer (rPC), yet many have not been compared head-to-head in comparative imaging studies. There is therefore an unmet need for evidence synthesis to guide evidence-based decisions in the selection of radiotracers. The objective of this study was therefore to assess the detection rate of various radiotracers for the rPC.

METHODS:

The PUBMED, EMBASE, and the EU and NIH trials databases were searched without date or language restriction for comparative imaging tracers for 13 radiotracers of principal interest. Key search terms included 18F-PSMA-1007, 18F-DCPFyl, 68Ga-PSMA-11, 18F-PSMA-11, 68Ga-PSMA-I&T, 68Ga-THP-PSMA, 64Cu-PSMA-617, 18F-JK-PSMA-7, 18F-Fluciclovine, 18F-FABC, 18F-Choline, 11C-Choline, and 68Ga-RM2. Studies reporting comparative imaging data in humans in rPC were selected. Single armed studies and matched pair analyses were excluded. Twelve studies with eight radiotracers were eligible for inclusion. Two independent reviewers screened all studies (using the PRISMA-NMA statement) for inclusion criteria, extracted data, and assessed risk of bias (using the QUADAS-2 tool). A network meta-analysis was performed using Markov-Chain Monte Carlo Bayesian analysis to obtain estimated detection rate odds ratios for each tracer combination.

RESULTS:

A majority of studies were judged to be at risk of publication bias. With the exception of 18F-PSMA-1007, little difference in terms of detection rate was revealed between the three most commonly used PSMA-radiotracers (68Ga-PSMA-11, 18F-PSMA-1007, 18F-DCFPyl), which in turn showed clear superiority to choline and fluciclovine using the derived network.

CONCLUSION:

Differences in patient-level detection rates were observed between PSMA- and choline-radiotracers. However, there is currently insufficient evidence to favour one of the four routinely used PSMA-radioligands (PSMA-11, PSMA-1007, PSMA-I&T, and DCFPyl) over another owing to the limited evidence base and risk of publication bias revealed by our systematic review. A further limitation was lack of reporting on diagnostic accuracy, which might favour radiotracers with low specificity in an analysis restricted only to detection rate. The NMA derived can be used to inform the design of future clinical trials and highlight areas where current evidence is weak.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Radioisótopos de Cobre Idioma: En Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Suíça

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Radioisótopos de Cobre Idioma: En Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Suíça