PET/MRI in Prostate Cancer: a Systematic Review and Meta-analysis

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2020 Sep 9

PMID 32901351

Citations 51

Authors

Laura Evangelista

Fabio Zattoni

Gianluca Cassarino

Paolo Artioli

Diego Cecchin

Fabrizio Dal Moro

Pietro Zucchetta

Affiliations

Soon will be listed here.

Abstract

Aim: In recent years, the clinical availability of scanners for integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) has enabled the practical potential of multimodal, combined metabolic-receptor, anatomical, and functional imaging to be explored. The present systematic review and meta-analysis summarize the diagnostic information provided by PET/MRI in patients with prostate cancer (PCa).

Materials And Methods: A literature search was conducted in three different databases. The terms used were "choline" or "prostate-specific membrane antigen - PSMA" AND "prostate cancer" or "prostate" AND "PET/MRI" or "PET MRI" or "PET-MRI" or "positron emission tomography/magnetic resonance imaging." All relevant records identified were combined, and the full texts were retrieved. Reports were excluded if (1) they did not consider hybrid PET/MRI; or (2) the sample size was < 10 patients; or (3) the raw data were not enough to enable the completion of a 2 × 2 contingency table.

Results: Fifty articles were eligible for systematic review, and 23 for meta-analysis. The pooled data concerned 2104 patients. Initial disease staging was the main indication for PET/MRI in 24 studies. Radiolabeled PSMA was the tracer most frequently used. In primary tumors, the pooled sensitivity for the patient-based analysis was 94.9%. At restaging, the pooled detection rate was 80.9% and was higher for radiolabeled PSMA than for choline (81.8% and 77.3%, respectively).

Conclusions: PET/MRI proved highly sensitive in detecting primary PCa, with a high detection rate for recurrent disease, particularly when radiolabeled PSMA was used.

Citing Articles

Current Clinical Applications of PSMA-PET for Prostate Cancer Diagnosis, Staging, and Treatment.

von Stauffenberg F, Poyet C, Beintner-Skawran S, Maurer A, Schmid F Cancers (Basel). 2025; 16(24.

PMID: 39766162 PMC: 11674651. DOI: 10.3390/cancers16244263.

A Pilot Study of PSMA PET/CT and MRI Fusion for Prostate Cancer: Software to Replace PET/MRI Hardware.

Mehawed G, Roberts M, Bugeja J, Dowling J, Stewart K, Gunasena R J Clin Med. 2024; 13(23).

PMID: 39685842 PMC: 11642359. DOI: 10.3390/jcm13237384.

Imaging of prostate micro-architecture using three-dimensional wide-field optical coherence tomography.

Skrok M, Tamborski S, Hepburn M, Fang Q, Maniewski M, Zdrenka M Biomed Opt Express. 2024; 15(12):6816-6833.

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Enhancing the diagnostic capacity of [F]PSMA-1007 PET/MRI in primary prostate cancer staging with artificial intelligence and semi-quantitative DCE: an exploratory study.

Glemser P, Freitag M, Kovacs B, Netzer N, Dimitrakopoulou-Strauss A, Haberkorn U EJNMMI Rep. 2024; 8(1):37.

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Advanced Nanomaterials for Cancer Therapy: Gold, Silver, and Iron Oxide Nanoparticles in Oncological Applications.

Singh P, Pandit S, Balusamy S, Madhusudanan M, Singh H, Amsath Haseef H Adv Healthc Mater. 2024; 14(4):e2403059.

PMID: 39501968 PMC: 11804848. DOI: 10.1002/adhm.202403059.

References

Lecouvet F, Oprea-Lager D, Liu Y, Ost P, Bidaut L, Collette L . Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group. Lancet Oncol. 2018; 19(10):e534-e545. DOI: 10.1016/S1470-2045(18)30571-0. View

Cimitan M, Evangelista L, Hodolic M, Mariani G, Baseric T, Bodanza V . Gleason score at diagnosis predicts the rate of detection of 18F-choline PET/CT performed when biochemical evidence indicates recurrence of prostate cancer: experience with 1,000 patients. J Nucl Med. 2015; 56(2):209-15. DOI: 10.2967/jnumed.114.141887. View

Graziani T, Ceci F, Castellucci P, Polverari G, Maria Lima G, Lodi F . (11)C-Choline PET/CT for restaging prostate cancer. Results from 4,426 scans in a single-centre patient series. Eur J Nucl Med Mol Imaging. 2016; 43(11):1971-9. DOI: 10.1007/s00259-016-3428-z. View

Fendler W, Calais J, Eiber M, Flavell R, Mishoe A, Feng F . Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer: A Prospective Single-Arm Clinical Trial. JAMA Oncol. 2019; 5(6):856-863. PMC: 6567829. DOI: 10.1001/jamaoncol.2019.0096. View

Whiting P, Rutjes A, Westwood M, Mallett S, Deeks J, Reitsma J . QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011; 155(8):529-36. DOI: 10.7326/0003-4819-155-8-201110180-00009. View

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

Abufaraj M, Grubmuller B, Zeitlinger M, Kramer G, Seitz C, Haitel A . Prospective evaluation of the performance of [Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy. Eur J Nucl Med Mol Imaging. 2019; 46(10):2169-2177. PMC: 6667405. DOI: 10.1007/s00259-019-04361-0. View

Wetter A, Lipponer C, Nensa F, Heusch P, Rubben H, Schlosser T . Quantitative evaluation of bone metastases from prostate cancer with simultaneous [18F] choline PET/MRI: combined SUV and ADC analysis. Ann Nucl Med. 2014; 28(5):405-10. DOI: 10.1007/s12149-014-0825-x. View

Souvatzoglou M, Eiber M, Takei T, Furst S, Maurer T, Gaertner F . Comparison of integrated whole-body [11C]choline PET/MR with PET/CT in patients with prostate cancer. Eur J Nucl Med Mol Imaging. 2013; 40(10):1486-99. DOI: 10.1007/s00259-013-2467-y. View

10.

Wetter A, Lipponer C, Nensa F, Heusch P, Rubben H, Altenbernd J . Evaluation of the PET component of simultaneous [(18)F]choline PET/MRI in prostate cancer: comparison with [(18)F]choline PET/CT. Eur J Nucl Med Mol Imaging. 2013; 41(1):79-88. DOI: 10.1007/s00259-013-2560-2. View

11.

Wetter A, Nensa F, Schenck M, Heusch P, Poppel T, Bockisch A . Combined PET imaging and diffusion-weighted imaging of intermediate and high-risk primary prostate carcinomas with simultaneous [18F] choline PET/MRI. PLoS One. 2014; 9(7):e101571. PMC: 4102471. DOI: 10.1371/journal.pone.0101571. View

12.

De Perrot T, Rager O, Scheffler M, Lord M, Pusztaszeri M, Iselin C . Potential of hybrid ¹⁸F-fluorocholine PET/MRI for prostate cancer imaging. Eur J Nucl Med Mol Imaging. 2014; 41(9):1744-55. DOI: 10.1007/s00259-014-2786-7. View

13.

Kim Y, Cheon G, Paeng J, Cho J, Kwak C, Kang K . Usefulness of MRI-assisted metabolic volumetric parameters provided by simultaneous (18)F-fluorocholine PET/MRI for primary prostate cancer characterization. Eur J Nucl Med Mol Imaging. 2015; 42(8):1247-56. DOI: 10.1007/s00259-015-3026-5. View

14.

Gatidis S, Scharpf M, Martirosian P, Bezrukov I, Kustner T, Hennenlotter J . Combined unsupervised-supervised classification of multiparametric PET/MRI data: application to prostate cancer. NMR Biomed. 2015; 28(7):914-22. DOI: 10.1002/nbm.3329. View

15.

Freitag M, Radtke J, Hadaschik B, Kopp-Schneider A, Eder M, Kopka K . Comparison of hybrid (68)Ga-PSMA PET/MRI and (68)Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer. Eur J Nucl Med Mol Imaging. 2015; 43(1):70-83. DOI: 10.1007/s00259-015-3206-3. View

16.

Wetter A, Gruneisen J, Fliessbach K, Lutje S, Schaarschmidt B, Umutlu L . Choline-based imaging of prostate cancer with combined [F] fluorocholine PET and H MR spectroscopy by means of integrated PET/MRI. Clin Imaging. 2017; 42:198-202. DOI: 10.1016/j.clinimag.2016.12.008. View

17.

Eiber M, Weirich G, Holzapfel K, Souvatzoglou M, Haller B, Rauscher I . Simultaneous Ga-PSMA HBED-CC PET/MRI Improves the Localization of Primary Prostate Cancer. Eur Urol. 2016; 70(5):829-836. DOI: 10.1016/j.eururo.2015.12.053. View

18.

Lutje S, Blex S, Gomez B, Schaarschmidt B, Umutlu L, Forsting M . Optimization of Acquisition time of 68Ga-PSMA-Ligand PET/MRI in Patients with Local and Metastatic Prostate Cancer. PLoS One. 2016; 11(10):e0164392. PMC: 5068705. DOI: 10.1371/journal.pone.0164392. View

19.

Domachevsky L, Bernstine H, Goldberg N, Nidam M, Stern D, Sosna J . Early GA-PSMA PET/MRI acquisition: assessment of lesion detectability and PET metrics in patients with prostate cancer undergoing same-day late PET/CT. Clin Radiol. 2017; 72(11):944-950. DOI: 10.1016/j.crad.2017.06.116. View

20.

Eiber M, Rauscher I, Souvatzoglou M, Maurer T, Schwaiger M, Holzapfel K . Prospective head-to-head comparison of C-choline-PET/MR and C-choline-PET/CT for restaging of biochemical recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2017; 44(13):2179-2188. DOI: 10.1007/s00259-017-3797-y. View