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European Urology Focus Jul 2022Prostate-specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) is a novel imaging technique with several potential... (Review)
Review
The Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Magnetic Resonance Imaging in Primary and Recurrent Prostate Cancer: A Systematic Review of the Literature.
CONTEXT
Prostate-specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) is a novel imaging technique with several potential applications in the prostate cancer (PCa) setting.
OBJECTIVE
To perform a systematic review of the current evidence regarding the diagnostic performance of PSMA PET/MRI in patients with primary and recurrent PCa.
EVIDENCE ACQUISITION
A comprehensive bibliographic search on the MEDLINE and Cochrane Library databases was performed in October 2020. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Studies were deemed eligible if they assessed patients with primary or recurrent PCa (P) undergoing PSMA PET/MRI (I) with or without comparison with other imaging techniques (C) in order to evaluate its diagnostic performance (O). Retrospective and prospective primary clinical studies were included. Results of previous meta-analyses were reported.
EVIDENCE SYNTHESIS
A total of 23 original articles and three meta-analyses were included. Limited evidence on PSMA PET/MRI is available, especially in the setting of partial gland ablation. PET/MRI can be an effective imaging modality for detecting primary PCa, showing higher accuracy than multiparametric MRI alone. It provides accurate local staging of primary PCa; however, there are contradictory results in this context when its performance is compared with other imaging techniques. PET/MRI also shows high performance for restaging and detecting tumor recurrence, even at low prostate-specific antigen levels.
CONCLUSIONS
PSMA PET/MRI could represent a valuable tool in the management of patients with primary and recurrent PCa. No specific recommendations can be provided.
PATIENT SUMMARY
Encouraging data regarding the benefits of prostate-specific membrane antigen positron emission tomography/magnetic resonance imaging in patients with prostate cancer are emerging from the literature.
Topics: Humans; Magnetic Resonance Imaging; Male; Neoplasm Recurrence, Local; Positron-Emission Tomography; Prospective Studies; Prostate; Prostate-Specific Antigen; Prostatic Neoplasms; Retrospective Studies
PubMed: 34538633
DOI: 10.1016/j.euf.2021.08.013 -
Journal of Oral and Maxillofacial... Sep 2015To detect the diagnostic efficacy of emission computed tomography (ECT) in detecting mandibular invasion caused by head and neck cancers. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To detect the diagnostic efficacy of emission computed tomography (ECT) in detecting mandibular invasion caused by head and neck cancers.
MATERIALS AND METHODS
Thirteen databases were searched electronically to retrieve studies for inclusion and a manual search also was conducted. Study inclusion, data extraction, and quality assessment were completed by 2 reviewers independently. Meta-DiSc 1.4 and STATA 11.0 were used to conduct the meta-analysis.
RESULTS
Seventeen studies involving 668 participants were included. One study had a low risk of bias, 2 had a high risk, and the rest had unclear risk. Meta-analysis showed that for the diagnosis of mandibular invasion single-photon ECT (SPECT) had a mean sensitivity (SEN) of 0.96, a mean specificity (SPE) of 0.66, an area under the curve (AUC) of 0.8989, and a Q* (point on the summary reviewer operator characteristic curve when SEN equaled SPE) of 0.8300. Positron emission tomography combined with computed tomography (PET/CT) had a mean SEN of 0.83, a mean SPE of 0.90, an AUC of 0.9290, and a Q* of 0.8640. The comparison between the diagnostic efficacy of SPECT and PET/CT showed that SPECT was superior for SEN (P = .0014) and PET/CT had a significantly better SPE (P = .001). The summary diagnostic efficacy between these modalities did not differ significantly (P > .05).
CONCLUSIONS
The present clinical evidence showed that SPECT is an excellent tool to exclude patients with no mandibular invasion, but is not as good as PET/CT to confirm the diagnosis.
Topics: Head and Neck Neoplasms; Humans; Mandibular Neoplasms; Multimodal Imaging; Neoplasm Invasiveness; Positron-Emission Tomography; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed
PubMed: 26022068
DOI: 10.1016/j.joms.2015.04.041 -
European Urology Oncology Aug 2022Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has gained acceptance as a staging tool for prostate cancer (PCa). Recent reports suggest an... (Meta-Analysis)
Meta-Analysis Review
Diagnostic Performance of Prostate-specific Membrane Antigen Positron Emission Tomography-targeted biopsy for Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis.
CONTEXT
Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has gained acceptance as a staging tool for prostate cancer (PCa). Recent reports suggest an association between PSMA PET and detection of clinically significant PCa (csPCa) on prostate biopsy.
OBJECTIVE
To assess the diagnostic accuracy of PSMA PET-targeted biopsy (PSMA-PET-TB) for csPCa detection.
EVIDENCE ACQUISITION
We searched PubMed, Web of Science, and Scopus in December 2021 to identify studies assessing the accuracy of PSMA-PET-TB for csPCa detection. A diagnostic meta-analysis was performed to calculate pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PSMA-PET-TB alone and in combination with magnetic resonance imaging (MRI)-TB for detecting csPCa.
EVIDENCE SYNTHESIS
Overall, five prospective studies involving 497 patients were eligible for this meta-analysis. For csPCa detection, PSMA-PET-TB had pooled sensitivity, specificity, PPV, and NPV of 0.89 (95% confidence interval [CI] 0.85-0.93), 0.56 (95% CI 0.29-0.80), 0.69 (95% CI 0.58-0.79), and 0.78 (95% CI 0.50-0.93), respectively. Among the three studies assessing the PSMA-PET + MRI-TB strategy, the pooled sensitivity, specificity, PPV, and NPV for csPCa detection were 0.91 (95% CI 0.77-0.97), 0.64 (95% CI 0.40-0.82), 0.75 (95% CI 0.56-0.87), and 0.85 (95% CI 0.62-0.95), respectively. For lesions with a Prostate Imaging-Reporting and Data System (PI-RADS) score of 3, the sensitivity, specificity, PPV, and NPV were 0.69, 0.73, 0.48, and 0.86, respectively.
CONCLUSIONS
PSMA-PET-TB appears to have favorable diagnostic accuracy for csPCa detection and combination with MRI seems to improve this. According to our meta-analysis, PSMA-PET has promising clinical application for detection of csPCa, namely in the case of PI-RADS 3 lesions. Further prospective studies are needed to explore the true clinical utility of a PSMA-PET-based diagnostic pathway.
PATIENT SUMMARY
Prostate-specific membrane antigen positron emission tomography (PSMA-PET) is a promising imaging method for detecting clinically significant prostate cancer and seems to have additional value to magnetic resonance imaging (MRI) for detection.
Topics: Biopsy; Humans; Magnetic Resonance Imaging; Male; Positron-Emission Tomography; Prospective Studies; Prostate; Prostatic Neoplasms
PubMed: 35715320
DOI: 10.1016/j.euo.2022.04.006 -
The British Journal of Oral &... Nov 2021Osteomyelitis is an inflammatory infectious disease that affects bone and bone marrow. Histopathology remains the gold standard method for diagnosis, but imaging... (Meta-Analysis)
Meta-Analysis Review
Osteomyelitis is an inflammatory infectious disease that affects bone and bone marrow. Histopathology remains the gold standard method for diagnosis, but imaging modalities also play an important role. We systematically reviewed five articles with comparative studies on plain films, computed tomography (CT) scan, magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), positron emission tomography (PET), single photon-emission computed tomography (SPECT), scintigraphy, and SPECT/CT. Scintigraphy and SPECT/CT has the highest sensitivity of 100%. PET is only to be used in cases of follow up. Orthopantomography (OPG) is the most common initial diagnostic tool despite its low sensitivity. CT provides the necessary specificity needed for radionuclide imaging, which has the highest negative predictive value of 100% and a positive predictive value >95%. SPECT/CT with 100% sensitivity and 85% specificity can be considered as the imaging modality of choice for initial diagnosis and follow up.
Topics: Humans; Magnetic Resonance Imaging; Osteomyelitis; Positron-Emission Tomography; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed
PubMed: 34503859
DOI: 10.1016/j.bjoms.2020.11.012 -
European Urology Oncology Jun 2021Management of newly diagnosed prostate cancer (PCa) is guided in part by accurate clinical staging. The role of imaging, including magnetic resonance imaging (MRI) and... (Review)
Review
The Role of Magnetic Resonance Imaging and Positron Emission Tomography/Computed Tomography in the Primary Staging of Newly Diagnosed Prostate Cancer: A Systematic Review of the Literature.
CONTEXT
Management of newly diagnosed prostate cancer (PCa) is guided in part by accurate clinical staging. The role of imaging, including magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT), in initial staging remains controversial.
OBJECTIVE
To systematically review the studies of MRI and/or PET/CT in the staging of newly diagnosed PCa with respect to tumor (T), nodal (N), and metastatic (M) staging (TNM staging).
EVIDENCE ACQUISITION
We performed a systematic review of the literature using MEDLINE and Web of Science databases between 2012 and 2020 following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines.
EVIDENCE SYNTHESIS
A total of 139 studies (83 on T, 47 on N, and 24 on M status) were included. Ninety-nine (71%) were retrospective, 39 (28%) were prospective, and one was a randomized controlled trial (RCT). Most studies on T staging examined MRI, while PET/CT was used primarily for N and M staging. Sensitivity for the detection of extraprostatic extension, seminal vesicle invasion, or lymph node invasion ranged widely. When imaging was incorporated into existing risk tools, gain in accuracy was observed in some studies, although these findings have not been replicated. For M staging, most favorable results were reported for prostate-specific membrane antigen (PSMA) PET/CT, which demonstrated significantly better performance than conventional imaging.
CONCLUSIONS
A variety of studies on modern imaging techniques for TNM staging in newly diagnosed PCa exist. For T and N staging, reported sensitivity of imaging modalities such as MRI or PET/CT varied widely due to data heterogeneity, small sample size, and low event rates resulting in large confidence intervals and a high level of uncertainty. Therefore, uniformity in data presentation and standardization on this topic are needed. The most promising technique for M staging, which was evaluated recently in an RCT, is PSMA-PET/CT.
PATIENT SUMMARY
We performed a systematic review of currently available imaging modalities to stage newly diagnosed prostate cancer. With respect to local tumor and lymph node assessment, performance of imaging ranged widely. However, prostate-specific membrane antigen positron emission tomography/computed tomography showed favorable results for the detection of distant metastases.
Topics: Humans; Lymph Nodes; Magnetic Resonance Imaging; Male; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Randomized Controlled Trials as Topic
PubMed: 33272865
DOI: 10.1016/j.euo.2020.11.002 -
International Journal of Molecular... Oct 2019Despite its name, prostate-specific membrane antigen (PSMA) has been shown using immunohistochemistry (IHC) to also be over-expressed in the tumor neovasculature of a... (Review)
Review
Despite its name, prostate-specific membrane antigen (PSMA) has been shown using immunohistochemistry (IHC) to also be over-expressed in the tumor neovasculature of a wide variety of solid tumors other than prostate carcinoma. Accordingly, positron-emitting radiolabeled small molecules targeting PSMA, initially developed for positron emission tomography in prostate carcinomas, are currently being explored for their staging and restaging potential as an alternative imaging modality in other solid tumor types where 18-F-fluorodeoxyglucose (FDG)-PET imaging has low diagnostic accuracy. In this paper, the currently available literature in this field is reviewed. Preliminary, mainly retrospective studies are encouraging, with evidence of improved diagnostic sensitivity and specificity in clear cell renal carcinoma, glioma, and hepatocellular carcinoma, leading to a change in patient management in several patients. However, the results published thus far warrant confirmation by larger prospective studies additionally assessing the longitudinal impact on patient outcomes.
Topics: Animals; Antigens, Surface; Diagnosis, Differential; Fluorodeoxyglucose F18; Glutamate Carboxypeptidase II; Humans; Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 31581638
DOI: 10.3390/ijms20194886 -
Acta Neuropathologica Communications Nov 2022Neuropathology and neuroimaging studies have identified several subtypes of Alzheimer's disease (AD): hippocampal sparing AD, typical AD, and limbic predominant AD. An... (Review)
Review
Neuropathology and neuroimaging studies have identified several subtypes of Alzheimer's disease (AD): hippocampal sparing AD, typical AD, and limbic predominant AD. An unresolved question is whether hippocampal sparing AD cases can present with neurofibrillary tangles (NFT) in association cortices while completely sparing the hippocampus. To address that question, we conducted a systematic review and performed original analyses on tau positron emission tomography (PET) data. We searched EMBASE, PubMed, and Web of Science databases until October 2022. We also implemented several methods for AD subtyping on tau PET to identify hippocampal sparing AD cases. Our findings show that seven out of the eight reviewed neuropathologic studies included cases at Braak stages IV or higher and therefore, could not identify hippocampal sparing cases with NFT completely sparing the hippocampus. In contrast, tau PET did identify AD participants with tracer retention in the association cortex while completely sparing the hippocampus. We conclude that tau PET can identify hippocampal sparing AD cases with NFT completely sparing the hippocampus. Based on the accumulating data, we suggest two possible pathways of tau spread: (1) a canonical pathway with early involvement of transentorhinal cortex and subsequent involvement of limbic regions and association cortices, and (2) a less common pathway that affects association cortices with limbic involvement observed at end stages of the disease or not at all.
Topics: Humans; Alzheimer Disease; Neurofibrillary Tangles; Positron-Emission Tomography; Hippocampus; Neuropathology; tau Proteins
PubMed: 36376963
DOI: 10.1186/s40478-022-01471-z -
European Journal of Cancer (Oxford,... Sep 201418F-fluoro-deoxy-glucose-positron emission tomography/computed tomography-scan (PET/CT) is used increasingly for detection of cancer. Precise diagnostic assessment of... (Meta-Analysis)
Meta-Analysis Review
UNLABELLED
18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography-scan (PET/CT) is used increasingly for detection of cancer. Precise diagnostic assessment of tumour extension in head and neck squamous cell carcinoma (HNSCC) is of critical importance for ensuring that patients receive proper treatment. Preliminary studies have shown divergent results of PET/CT in diagnosis and staging of HNSCC. The aims of this study were (1) to systematically review and meta-analyse published data about the diagnostic accuracy of PET/CT for diagnosing patients with HNSCC and (2) to compare the diagnostic accuracy of PET/CT with that of standard conventional imaging (SCI).
METHODS
A systematic literature search in the PubMed, Embase and Cochrane databases on publications of PET/CT diagnostics of HNSCC from January 2005 to July 2013 was carried out. All retrieved studies were reviewed and qualitatively analysed. Along with the calculated pooled sensitivity and specificity of PET/CT and SCI, bubble- and summary receiver operating characteristics (SROC) plots were created.
FINDINGS
Two meta-analyses of diagnostic accuracy were conducted. The first, on PET/CT, included 987 patients distributed across nine studies. The second, on SCI, included 517 patients participating in a total of six studies among those comparing PET/CT to SCI. The meta-analyses showed a pooled sensitivity of 89.3% (95% confidence interval [95% CI]: 83.4-93.2%) and specificity of 89.5% (95% CI: 82.9-93.7%) for PET/CT and correspondingly, a pooled sensitivity and specificity of 71.6% (95% CI: 44.3-88.9%) and 78.0% (95%CI: 30.2-96.7%) for SCI. A graphical comparison to SCI showed a clear difference in favour of PET/CT.
INTERPRETATION
PET/CT is highly accurate in diagnosing patients suffering from HNSCC.
Topics: Carcinoma, Squamous Cell; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Multimodal Imaging; Positron-Emission Tomography; Radiopharmaceuticals; Squamous Cell Carcinoma of Head and Neck; Tomography, X-Ray Computed
PubMed: 25011659
DOI: 10.1016/j.ejca.2014.05.015 -
Radiotherapy and Oncology : Journal of... Apr 2017PET/CT is a proposed management to improve the accuracy of high dose radiochemotherapy in lung cancer patients. This systematic review was performed to investigate the... (Meta-Analysis)
Meta-Analysis Review
Positron emission tomography and computed tomographic imaging (PET/CT) for dose planning purposes of thoracic radiation with curative intent in lung cancer patients: A systematic review and meta-analysis.
BACKGROUND AND PURPOSE
PET/CT is a proposed management to improve the accuracy of high dose radiochemotherapy in lung cancer patients. This systematic review was performed to investigate the possible impact on clinical outcome and to quantify the effect on patient selection and target definition.
MATERIAL AND METHODS
Systematic literature searches were conducted, eligible full-text articles were assessed for quality and data were extracted.
RESULTS
Thirty-five cross-sectional studies and one observational study fulfilled the inclusion criteria. No randomized trials or data with regard to clinical endpoints were found. The summary estimates of a change in target definition were 36% in patients with a former staging PET, and 43% and 26% in patients without a staging PET, for non small- and small cell lung cancer respectively. The corresponding summary estimates of a change in treatment intent from curative to palliative treatment were 20% and 22% and 9% respectively.
CONCLUSION
PET/CT for dose planning improves target definition and patient selection. Approximately two in five patients had a significant change in target definition and one in five received palliative treatment instead. The proportions seem to be similar regardless of the availability of a previous staging-PET.
Topics: Cross-Sectional Studies; Female; Humans; Lung Neoplasms; Male; Patient Selection; Positron Emission Tomography Computed Tomography; Radiotherapy Planning, Computer-Assisted; Thorax
PubMed: 28284494
DOI: 10.1016/j.radonc.2017.02.011 -
Clinical Endocrinology Sep 2023Minimally invasive parathyroidectomy (MIP) is the standard of care for primary hyperparathyroidism (PHPT). Four dimensional computed tomography(4DCT) and F-18... (Meta-Analysis)
Meta-Analysis
Comparison of 4D computed tomography and F-18 fluorocholine PET for localisation of parathyroid lesions in primary hyperparathyroidism: A systematic review and meta-analysis.
Minimally invasive parathyroidectomy (MIP) is the standard of care for primary hyperparathyroidism (PHPT). Four dimensional computed tomography(4DCT) and F-18 Fluorocholine positron emission tomography/computed tomography (FCH PET/CT) localize adenomas accurately to perform MIP. We aimed to conduct a systematic review and metanalysis to evaluate the diagnostic performance of 4DCT and FCH PET/CT scan for quadrant wise localisation in PHPT patients and to do head-to-head comparison between these two modalities. DESIGN, PATIENTS AND MEASUREMENT : After searching through PubMed and EMBASE databases, 46 studies (using histology as a gold standard) of 4DCT and FCH PET/CT were included. RESULTS: Total number of patients included were 1651 and 952 for 4DCT scan (studies n = 26) and FCH PET/CT scan (studies n = 24) respectively. In per patient analysis, FCH PET/CT and 4DCT had pooled sensitivities of 92% (88-94) and 85% (73-92) respectively and in per lesion analysis, 90% (86-93) and 79% (71-84), respectively. In the subgroup with negative conventional imaging/persistent PHPT, FCH PET/CT had comparable sensitivity to 4DCT (84% [74-90] vs. 72% [46-88]). As per patient wise analysis, FCH PET/CT had better detection rates than 4DCT ([92.4 vs. 76.85], odds ratio -3.89 [1.6-9.36] p = .0024) in the subpopulation where both FCH PET/CT and 4DCT were reported. CONCLUSION: Both 4DCT and FCH PET/CT scan performed well in newly diagnosed patients, patients with persistent disease and in those with inconclusive conventional imaging results. FCH PET/CT scan had a higher pooled sensitivity than 4DCT in detecting patients with PHPT in head to head comparison.
Topics: Humans; Positron Emission Tomography Computed Tomography; Four-Dimensional Computed Tomography; Hyperparathyroidism, Primary; Parathyroid Glands; Choline
PubMed: 36593125
DOI: 10.1111/cen.14875