Dataset Information

Diagnostic performance of choline PET/CT for the detection of bone metastasis in prostate cancer: A systematic review and meta-analysis.

ABSTRACT:

Purpose

The aim of this study was to evaluate the diagnostic performance of choline positron emission tomography/computed tomography (PET/CT) for the detection of bone metastasis in patients with prostate cancer.

Methods

MEDLINE, EMBASE and the Cochrane Library were searched up to 20 February 2018 for studies that used 11C-choline or 18F-choline PET/CT for the detection of bone metastasis in patients with prostate cancer and "histopathology and/or clinical follow-up" as the reference standard. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Pooled diagnostic accuracy with the 95% confidence interval (CI) was calculated using a bivariate random effects model. We also constructed hierarchical summary receiver operating characteristic curves and performed meta-regression analyses.

Results

Fourteen studies with reasonable methodological quality were included in the analysis. On a per-patient basis, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 0.89 (95% CI 0.80-0.94), 0.98 (95% CI 0.95-0.99), 40.4 (95% CI 19.7-82.6), 0.12 (95% CI 0.07-0.20), and 344 (95% CI 148-803), respectively. On a per-lesion basis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.91 (95% CI 0.85-0.94), 0.97 (95% CI 0.95-0.98), 34.1 (95% CI 20.0-58.1), 0.10 (95% CI 0.06-0.16), and 358 (95% CI 165-778), respectively. In the meta-regression analysis, the clinical setting (staging vs. restaging) was the only source of study heterogeneity on a per-patient basis.

Conclusions

Choline PET/CT shows excellent diagnostic performance for the detection of bone metastasis. However, a negative choline PET/CT result cannot ensure the lack of bone metastasis.

SUBMITTER: Guo Y

PROVIDER: S-EPMC6128558 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Diagnostic performance of choline PET/CT for the detection of bone metastasis in prostate cancer: A systematic review and meta-analysis.

Guo Yu Y Wang Ling L Hu Junjie J Feng Dehong D Xu Lijuan L

PloS one 20180907 9

<h4>Purpose</h4>The aim of this study was to evaluate the diagnostic performance of choline positron emission tomography/computed tomography (PET/CT) for the detection of bone metastasis in patients with prostate cancer.<h4>Methods</h4>MEDLINE, EMBASE and the Cochrane Library were searched up to 20 February 2018 for studies that used 11C-choline or 18F-choline PET/CT for the detection of bone metastasis in patients with prostate cancer and "histopathology and/or clinical follow-up" as the refere ...[more]

PMID: 30192819

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Project description:Our purpose was to determine the relationship between serum prostate-specific antigen (PSA) level categories (<5, 5-10, 10-20, and >20 ng/mL) and the incidence of bone metastases detected by total-body 68Ga-prostate-specific membrane antigen (PSMA)-11 PET/CT and to assess if expanding the 68Ga-PSMA-11 PET/CT imaging field to include the vertex and lower extremities (total-body acquisition) affects bone metastasis detection rates and patient management. Methods: This was a retrospective analysis of 388 prostate cancer patients enrolled in 5 prospective studies (NCT02940262, NCT03368547, NCT03042312, NCT04050215, and NCT03515577). All underwent 68Ga-PSMA-11 PET/CT scans acquired from vertex to toes for primary staging (n = 93/388, 24%), biochemical recurrence (BCR) localization (n = 225/388, 58%), or restaging metastatic disease (M1) before or during systemic therapy (n = 70/388, 18%) between September 2017 and May 2018. Results: In total, 321 of 388 patients (83%) had a positive 68Ga-PSMA-11 study. PSMA-positive bone lesions were found in 105 of 388 (27%) patients, with an incidence that was positively associated with serum PSA level (<10 ng/mL, 21%; 10-20 ng/mL, 41%; ≥20 ng/mL, 41%; P < 0.001). This association was maintained for all 3 indications: initial staging, BCR, and restaging M1. Bone metastases occurred most frequently in restaging M1, followed by BCR and initial staging. Bone metastasis incidence was not significantly associated with National Comprehensive Cancer Network risk score (P = 0.22). The average number of PSMA-positive regions also increased with serum PSA level (P < 0.001). Eighteen of 388 (5%) and 18 of 388 (5%) had lesions above the superior orbital ridge and below the proximal third of the femur, respectively. There was only 1 of 388 patients (0.26%) in whom the total-body PET acquisition had an impact on management. Conclusion: Bone metastases as assessed with 68Ga-PSMA-11 PET/CT are prevalent even in patients with low serum PSA levels. Therefore, current guidelines for bone assessments in prostate cancer patients should be revisited because 68Ga-PSMA-11 PET/CT may provide additional information for accurate bone staging at low serum PSA levels. Including the total body (from vertex to toes) in 68Ga-PSMA-11 PET/CT imaging revealed additional bone lesions in 6% of patients, but without significantly affecting patient management.

Dataset Information

Diagnostic performance of choline PET/CT for the detection of bone metastasis in prostate cancer: A systematic review and meta-analysis.

Purpose

Methods

Results

Conclusions

Publications

Diagnostic performance of choline PET/CT for the detection of bone metastasis in prostate cancer: A systematic review and meta-analysis.

Similar Datasets

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