PET CT and PET MRI comparable for diagnosing prostate cancer

Prostate cancer is one of the most prevalent malignancies among men, and its recurrence after treatment remains a significant concern. Researchers have been exploring advanced imaging techniques to improve the detection of recurrent prostate cancer. Two promising modalities, 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI, have been under scrutiny. A recent systematic review and meta-analysis published in Frontiers In Oncology by Ruizhe Huang and colleagues sought to determine their relative diagnostic efficacy in detecting biochemically recurrent prostate cancer.

The study, which reviewed relevant literature up to February 2023, delved into PubMed, Embase, and Web of Science for pertinent papers. Inclusion criteria encompassed studies evaluating 68Ga-PSMA-11 PET/CT or PET/MRI as screening tools for biochemically recurrent prostate cancer. The researchers employed statistical methods to measure heterogeneity and produce a forest plot. The quality of the studies was assessed using the Quality Assessment of Diagnostic Performance Studies (QUADAS-2) method. The findings of the study were:

● Comparable Detection Rates: The analysis included 37 studies involving 8,409 patients. The combined total detection rate for 68Ga-PSMA-11 PET/CT was 70%, with a 95% confidence interval (CI) of 65% to 75%. For 68Ga-PSMA-11 PET/MRI, the detection rate was 71%, with a 95% CI of 67% to 75%.

● These results indicate that both imaging modalities exhibit similar performance in detecting biochemically recurrent prostate cancer.

● No Significant Difference: The study found that 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI did not substantially differ in terms of the overall detection rate for biochemically recurrent prostate cancer. Statistical analysis supported this finding (P = 0.58).

● PSA Levels Impact: Interestingly, the detection rate was unaffected by PSA values, indicating that both modalities maintain their diagnostic efficacy regardless of the PSA level (all P > 0.05).

The systematic review and meta-analysis suggest that 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI exhibit comparable diagnostic efficacy in detecting biochemically recurrent prostate cancer. However, it is essential to note that not all studies employed pathological biopsies as the gold standard for validation. Therefore, further research, particularly larger prospective studies, is needed to address this issue comprehensively.

These findings contribute to the ongoing efforts to enhance the detection and management of recurrent prostate cancer, potentially offering more personalized and effective treatment strategies for affected individuals.

Reference:

Huang, R., Li, Y., Wu, H., Liu, B., Zhang, X., & Zhang, Z. (2023). 68Ga-PSMA-11 PET/CT versus 68Ga-PSMA-11 PET/MRI for the detection of biochemically recurrent prostate cancer: a systematic review and meta-analysis. Frontiers in Oncology, 13. https://doi.org/10.3389/fonc.2023.1216894