The use of prostate-specific membrane antigen (PSMA)-targeted agents for staging prostate cancer (PCa) patients using positron emission tomography/computed tomography (PET/CT) is increasing worldwide. We performed a systematic review on the role of ¹⁸ F-PSMA-1007 PET/CT in PCa staging to provide evidence-based data in this setting.
A comprehensive computer literature search of PubMed/MEDLINE and Cochrane Library databases for studies using ¹⁸ F-PSMA-1007 PET/CT in PCa staging was performed until 31 December 2020. Eligible articles were selected and relevant information was extracted from the original articles by two authors independently.
Eight articles (369 patients) evaluating the role of ¹⁸ F-PSMA-1007 PET/CT in PCa staging were selected. These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of ¹⁸ F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Overall, higher primary PCa aggressiveness was associated with higher ¹⁸ F-PSMA-1007 uptake. When compared with other radiological and scintigraphic imaging methods, ¹⁸ F-PSMA-1007 PET/CT had superior sensitivity in detecting metastatic disease and the highest inter-reader agreement. ¹⁸ F-PSMA-1007 PET/CT showed similar results in terms of diagnostic accuracy for PCa staging compared with PET/CT with other PSMA-targeted tracers. Dual imaging with multi-parametric magnetic resonance imaging and ¹⁸ F-PSMA-1007 PET/CT may improve staging of primary PCa. Notably, ¹⁸ F-PSMA-1007-PET/CT may detect metastatic disease in a significant number of patients with negative standard imaging.
¹⁸ F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging. Prospective multicentric studies are needed to confirm these findings.