Meta-analysis of F-PSMA-1007 PET/CT, F-FDG PET/CT, and Ga-PSMA PET/CT in diagnostic efficacy of prostate Cancer.

Objective: To compare  F-PSMA-1007 PET/CT,  F-FDG PET/CT and Ga-PSMA PET/CT in the diagnostic value of prostate cancer.

Method: The Chinese and foreign databases, such as Pubmed, Cochrane Library, Embase, CNKI, VIP, Wanfang, etc., were systematically searched within the period from the establishment of the database to June 1, 2022. Clinical studies related to the diagnosis of prostate cancer by methods such as  F-PSMA-1007 PET/CT,  F-FDG PET/CTCT, Ga-PSMA PET/CT, were researched. Two (2) investigators independently screened literatures, extracted data, and assessed the risk of bias when these data were included in the studies with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Review Manager5.4, Stata 14.0, and Meta-disc 1.4 software were used for meta-analysis to compare the efficacy of different methods in the diagnose of prostate cancer.

Results: Twenty-seven (27) studies, including 2891 subjects were included in our study. Meta-analysis results showed that the pooled sensitivities of  F-PSMA-1007 PET/CT,  F-FDG PET/CT, and Ga-PSMA PET/CT were 0.912 (95%CI: 0.883-0.936), 0.748 (95%CI: 0.698-0.795), and 0.916 (95%CI: 0.896-0.934), respectively; the pooled specification were 0.878 (0.844-0.907), 0.639 (95%CI: 0.589-0.687), and 0.734 (95%CI: 0.685-0.779), respectively; the positive likelihood ratios were 6.335 (95%CI: 4.288-9.357), 2.282 (95%CI: 1.497-3.477), and 3.593 (95%CI: 2.986-4.323), respectively; the negative likelihood ratios were 0.878 (95%CI: 0.844-0.907), 0.374 (95%CI: 0.280-0.499), and 0.110 (95%CI: 0.083-0.144), respectively; the diagnostic odds ratios were 65.125 (95%CI: 34.059-124.53), 7.094 (95%CI: 4.091-12.301), and 29.722 (95%CI: 20.141-43.863), respectively; the positive posterior probability was 64%, 38%, and 62%, respectively; the area under the SPOC curve was 0.95 (95%CI: 0.93-0.97), 0.81 (95%CI: 0.78-0.84), and 0.96 (95%CI: 0.92-0.98), respectively. The funnel plots indicated that there was no significant publication bias in the included literatures.

Conclusion: The current evidences showed that  F-PSMA-1007 PET/CT and Ga-PSMA PET/CT had higher diagnostic efficacy of prostate cancer compared with  F-FDG PET/CT, among which Ga-PSMA PET/CT was slightly higher in the sensitivity of the diagnosis of prostate cancer, while  F-PSMA-1007 PET/CT may have higher efficacy in specificity and confirmed positive rate. Due to the limitations of the quality of the included samples and literatures, the above conclusions should be further validated by expanding the sample size and improving the quality.