The Detection Performance of 18F-Prostate-Specific Membrane Antigen-1007 PET/CT in Primary Prostate Cancer A Systemic Review and Meta-analysis

Background Multiple tools are now available to determine the requirement for a biopsy to diagnose prostate cancer, and PET/CT with radiolabeled prostate-specific membrane antigen (PSMA)-targeting radiotracers has been recommended for detecting primary prostate cancer. Particularly, the radiotracer F-18-PSMA-1007 was found to be more favorable for primary tumors compared with other PSMA-targeting radiotracers because of its low clearance via the urinary tract and better image resolution. Thus, we performed a systematic review and meta-analysis to more accurately evaluate the detection performance of F-18-PSMA-1007 PET/CT in primary prostate cancer patients. Methods An update on the databases of PubMed/MEDLINE, EMBASE, and Cochrane Library for comprehensive literature search was performed on September 30, 2021. The pooling detection rate was calculated on a per-patient basis. The pooling median of the SUVmax was analyzed from the included studies. Furthermore, the positive predictive value of F-18-PSMA-1007 PET/CT with pathologic lesions was analyzed using the criterion standard. Results Twelve studies (540 patients total) were included in the meta-analysis. The overall pooling detection rate of F-18-PSMA-1007 per patient was 94%, and the pooling median of SUVmax located at the intraprostate tumor was 16 (range, 3.7-77.7). The positive predictive value of F-18-PSMA-1007 per lesion with histopathological validation was 0.90, detecting regional lymph node metastasis was 0.94, and detecting localized prostatic tumors was 0.84. Conclusions In the current meta-analysis, we revealed the excellent performance of F-18-PSMA-1007 to detect localized prostatic tumor lesions and regional lymph node metastasis. Moreover, the uptake of localized tumors in primary prostate cancer was nearly liver uptake and may be considered a suspicious malignancy if it was equal to or greater than the liver uptake.