A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies
Context: Prostate cancer (PCa) remains one of the leading causes of cancer-related deaths in men worldwide. Men at risk are typically offered multiparametric magnetic resonance imaging and, if suspicious, a targeted biopsy. However, false-negative rates of magnetic resonance imaging are consistently...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266616832300099X |
| _version_ | 1827968099916185600 |
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| author | Gideon Ptasznik Daniel Moon James Buteau Brian D. Kelly Sean Ong Declan G. Murphy Mark Page Nathan Papa |
| author_facet | Gideon Ptasznik Daniel Moon James Buteau Brian D. Kelly Sean Ong Declan G. Murphy Mark Page Nathan Papa |
| author_sort | Gideon Ptasznik |
| collection | DOAJ |
| description | Context: Prostate cancer (PCa) remains one of the leading causes of cancer-related deaths in men worldwide. Men at risk are typically offered multiparametric magnetic resonance imaging and, if suspicious, a targeted biopsy. However, false-negative rates of magnetic resonance imaging are consistently 18%; therefore, there is growing interest in improving the diagnostic performance of imaging through novel technologies. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is being utilised for PCa staging and, more recently, for intraprostatic tumour localisation. However, significant variability has been observed in how PSMA PET is performed and reported. Objective: In this review, we aim to evaluate how pervasive this variability is in trials investigating the performance of PSMA PET in primary PCa workup. Evidence acquisition: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed an optimal search in five different databases. After removing duplicates, 65 studies were included in our review. Evidence synthesis: Studies dated back as early as 2016, with numerous different source countries. There was variation in the reference standard for PSMA PET, with some using biopsy specimens or surgical specimens, and in some cases, a combination of the two. Similar inconsistencies were noted when studies selected histological definitions of clinically significant PCa, while some omitted their definition altogether. The most significant variations in performing PSMA PET were the radiotracer type, dose, acquisition time after injection, and the PET camera being utilised. Substantial variation in the reporting of PSMA PET was noted, with no consistency in defining what constitutes a positive intraprostatic lesion. Across 65 studies, four different definitions were used. Conclusions: This systematic review has highlighted considerable variation in obtaining and performing a PSMA PET study in the context of primary PCa diagnosis. Given the discrepancy in how PSMA PET was performed and reported, it questions the homogony of studies from centre to centre. Standardisation of PSMA PET is required for this to become a consistently useful and reproducible modality in the diagnosis of PCa. Patient summary: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is being utilised for staging and localisation of prostate cancer (PCa); however, there is significant variability in performing and reporting PSMA PET. Standardisation of PSMA PET is required for results to be consistently useful and reproducible for the diagnosis of PCa. |
| first_indexed | 2024-04-09T18:15:56Z |
| format | Article |
| id | doaj.art-a8ec0ebe22f840d8975afb8c43d481c3 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-09T18:15:56Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-a8ec0ebe22f840d8975afb8c43d481c32023-04-13T04:27:08ZengElsevierEuropean Urology Open Science2666-16832023-04-015091105A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging StudiesGideon Ptasznik0Daniel Moon1James Buteau2Brian D. Kelly3Sean Ong4Declan G. Murphy5Mark Page6Nathan Papa7Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Young Urology Research Organisation (YURO), Melbourne, VIC, Australia; Corresponding author. Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. Tel. +61 437 951 214.School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; University of Melbourne, Royal Melbourne Hospital Clinical School, Melbourne, VIC, AustraliaProstate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC) and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, AustraliaDivision of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, AustraliaUniversity of Melbourne, Royal Melbourne Hospital Clinical School, Melbourne, VIC, Australia; EJ Whitten Foundation Prostate Cancer Research Centre at Epworth, Melbourne, VIC, AustraliaDivision of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, AustraliaSt Vincent’s Hospital, Melbourne, VIC, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, AustraliaContext: Prostate cancer (PCa) remains one of the leading causes of cancer-related deaths in men worldwide. Men at risk are typically offered multiparametric magnetic resonance imaging and, if suspicious, a targeted biopsy. However, false-negative rates of magnetic resonance imaging are consistently 18%; therefore, there is growing interest in improving the diagnostic performance of imaging through novel technologies. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is being utilised for PCa staging and, more recently, for intraprostatic tumour localisation. However, significant variability has been observed in how PSMA PET is performed and reported. Objective: In this review, we aim to evaluate how pervasive this variability is in trials investigating the performance of PSMA PET in primary PCa workup. Evidence acquisition: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed an optimal search in five different databases. After removing duplicates, 65 studies were included in our review. Evidence synthesis: Studies dated back as early as 2016, with numerous different source countries. There was variation in the reference standard for PSMA PET, with some using biopsy specimens or surgical specimens, and in some cases, a combination of the two. Similar inconsistencies were noted when studies selected histological definitions of clinically significant PCa, while some omitted their definition altogether. The most significant variations in performing PSMA PET were the radiotracer type, dose, acquisition time after injection, and the PET camera being utilised. Substantial variation in the reporting of PSMA PET was noted, with no consistency in defining what constitutes a positive intraprostatic lesion. Across 65 studies, four different definitions were used. Conclusions: This systematic review has highlighted considerable variation in obtaining and performing a PSMA PET study in the context of primary PCa diagnosis. Given the discrepancy in how PSMA PET was performed and reported, it questions the homogony of studies from centre to centre. Standardisation of PSMA PET is required for this to become a consistently useful and reproducible modality in the diagnosis of PCa. Patient summary: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is being utilised for staging and localisation of prostate cancer (PCa); however, there is significant variability in performing and reporting PSMA PET. Standardisation of PSMA PET is required for results to be consistently useful and reproducible for the diagnosis of PCa.http://www.sciencedirect.com/science/article/pii/S266616832300099XProstate-specific membrane antigen positron emission tomographyPrimary prostate cancerPrimary localisationNovel imaging |
| spellingShingle | Gideon Ptasznik Daniel Moon James Buteau Brian D. Kelly Sean Ong Declan G. Murphy Mark Page Nathan Papa A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies European Urology Open Science Prostate-specific membrane antigen positron emission tomography Primary prostate cancer Primary localisation Novel imaging |
| title | A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies |
| title_full | A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies |
| title_fullStr | A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies |
| title_full_unstemmed | A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies |
| title_short | A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies |
| title_sort | systematic review of the variability in performing and reporting intraprostatic prostate specific membrane antigen positron emission tomography in primary staging studies |
| topic | Prostate-specific membrane antigen positron emission tomography Primary prostate cancer Primary localisation Novel imaging |
| url | http://www.sciencedirect.com/science/article/pii/S266616832300099X |
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