Purpose Numerous radiotracers are currently available for the detection of recurrent prostate cancer (rPC), yet many have not been compared head-to-head in comparative imaging studies. There is therefore an unmet need for evidence synthesis to guide evidence-based decisions in the selection of radiotracers. The objective of this study was to assess the detection rate of various radiotracers for the rPC. Methods The PUBMED, EMBASE, and the EU and NIH trials databases were searched without date or language restriction for comparative imaging tracers for 13 radiotracers of principal interest. Key search terms included 18F-PSMA-1007, 18F-DCPFyl, 68Ga-PSMA-11, 18F-PSMA-11, 68Ga-PSMA-I&T, 68Ga-THP-PSMA, 64Cu-PSMA-617, 18F-JK-PSMA-7, 18F-Fluciclovine, 18F-FABC, 18F-Choline, 11C-Choline, and 68Ga-RM2. Studies reporting comparative imaging data in humans in rPC were selected. Single armed studies and matched pair analyses were excluded. Twelve studies with eight radiotracers were eligible for inclusion. Two independent reviewers screened all studies (using the PRISMA-NMA statement) for inclusion criteria, extracted data, and assessed risk of bias (using the QUADAS-2 tool). A network meta-analysis was performed using Markov-Chain Monte Carlo Bayesian analysis to obtain estimated detection rate odds ratios for each tracer combination. Results A majority of studies were judged to be at risk of publication bias. With the exception of 18F-PSMA-1007, little difference in terms of detection rate was revealed between the three most commonly used PSMA-radiotracers (68Ga-PSMA-11, 18F-PSMA-1007, 18F-DCFPyl), which in turn showed clear superiority to choline and fluciclovine using the derived network. Conclusion Differences in patient-level detection rates were observed between PSMA- and choline-radiotracers. However, there is currently insufficient evidence to favour one of the four routinely used PSMA-radioligands (PSMA-11, PSMA-1007, PSMA-I&T, and DCFPyl) over another owing to the limited evidence base and risk of publication bias revealed by our systematic review. A further limitation was lack of reporting on diagnostic accuracy, which might favour radiotracers with low specificity in an analysis restricted only to detection rate. The NMA derived can be used to inform the design of future clinical trials and highlight areas where current evidence is weak.
The aim of the study was to investigate the time-dependent increase in the knee extensors' isometric strength as a response to voluntary, unilateral, isometric knee extension exercise (UIKEE). To do so, a systematic review was carried out to obtain data for a Bayesian longitudinal model-based meta-analysis (BLMBMA). For the systematic review, PubMed, Web of Science, SCOPUS, Chochrane Library were used as databases. The systematic review included only studies that reported on healthy, young individuals performing UIKEE. Studies utilizing a bilateral training protocol were excluded as the focus of this review lied on unilateral training. Out of the 3,870 studies, which were reviewed, 20 studies fulfilled the selected inclusion criteria. These 20 studies were included in the BLMBMA to investigate the time-dependent effects of UIKEE. If compared to the baseline strength of the trained limb, these data reveal that UKIEE can increase the isometric strength by up to 46%. A meta-analysis based on the last time-point of each available study was employed to support further investigations into UIKEE-induced strength increase. A sensitivity analysis showed that intensity of training (%MVC), fraction of male subjects and the average age of the subject had no significant influence on the strength gain. Convergence of BLMBMA revealed that the peak strength increase is reached after ~4 weeks of UIKEE training.
ObjectivesTo compare clinical parameters of implants versus natural teeth over a period of 5 years during supportive periodontal therapy (SPT).Material and MethodsA total of 421 SPT patients were screened for implants (I) and corresponding control teeth (C). Data (patient level [P]: sex, age, smoking status, systemic diseases, adherence, oral hygiene indices, mean probing depth [PD]P, bleeding on probing [BOP]P, periodontal risk profile; implant/control tooth level [I/C]: PDI/C, BOPI/C; site level at implants [SITE]: position, dental arch, aspect, BOPSITE) were assessed at the first SPT session where the implant was probed (T1) and 5 years later (T2). The influence of patient and implant/control‐related factors on PDI/C/BOPI/C was tested (linear mixed model) as well as the influence of site‐specific factors on the PDSITE change (multilevel regression).ResultsA total of 70 patients (151 implants) were included. Mean PDI was 2.75 ± 0.85 mm (T1) and 2.87 ± 0.79 mm (T2). Mean PDC was 2.42 ± 0.66 mm (T1) and 2.49 ± 0.71 mm (T2). BOPI increased from 8.62 ± 15.01% (T1) to 24.06 ± 26.79% (T2) and BOPC from 9.97 ± 17.78% (T1) to 15.52 ± 22.69% (T2). The differences between implants and controls were significant for BOP (p = .0032). At T2, BOPI/C was associated with periodontal risk (p = .0351). The site‐specific analysis revealed an association of BOPSITE at T1 with the progression of PDSITE (p = .0058).ConclusionsProbing depths of implants and controls seem to change similarly during SPT but retention of inflammation‐free conditions at implants appears to be more difficult compared to natural teeth. Patients with a high‐risk profile appear to have an increased susceptibility for BOP around implants, and BOP at implants seems to be a predictor for further PD increase.
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