Diagnostic accuracy of 18F-PSMA-1007 PET/CT for prostate cancer in primary staging and biochemical recurrence with different serum PSA levels: A systematic review and meta-analysis.

We performed a systematic review and meta-analysis to evaluate the application value of fluorine-18-prostate specific membrane antigen (18F-PSMA-1007) positron emission tomography/computed tomography (PET/CT) in patients with different serum prostate specific antigen (PSA) levels and primary prostate cancer (PCa) or the biochemical recurrence of PCa.A comprehensive electronic literature search of the PubMed, Embase and Cochrane Library databases was conducted in accordance with the PRISMA statement. We calculated the pooled sensitivity and specificity of 18F-PSMA-1007 PET/CT in PCa. A summary receiver operator characteristic (SROC) curve and the area under the curve (AUC) were used to assess the accuracy of 18F-PSMA-1007 PET/CT for PCa.The final analysis included 11 studies that described 799 patients and 4261 lesions with 18F-PSMA-1007 PET/CT in PCa. The pooled sensitivity and specificity of 18F-PSMA-1007 PET/CT in PCa were 0.836 and 0.946, respectively. The per-patient pooled sensitivity and specificity of 18F-PSMA-1007 PET/CT in PCa were 0.934 and 0.453, and the per-lesion values were 0.816 and 0.979, respectively. The pooled sensitivity and specificity of 18F-PSMA-1007 PET/CT in PCa with PSA>2ng/mL were 0.923 and 0.442 in a patient-based analysis and 0.799 and 0.961 in a lesion-based analysis, respectively. The pooled sensitivity and specificity of 18F-PSMA-1007 PET/CT in PCa with PSA≤2ng/mL were 0.832 and 0.277 in a patient-based analysis, respectively.This meta-analysis showed that 18F-PSMA-1007 PET/CT has a higher diagnostic value for prostate cancer in the setting of primary PCa and biochemical recurrence. As serum PSA levels increase, the diagnostic accuracy of 18F-PSMA-1007 PET/CT also improves.