Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer—Updated Diagnostic Utility, Sensitivity, Specificity, and Distribution of Prostate-specific Membrane Antigen-avid Lesions: A Systematic Review and Meta-analysis

Risk of metastatic disease on 68gallium‐prostate‐specific membrane antigen positron emission tomography/computed tomography scan for primary staging of 1253 men at the diagnosis of prostate cancer

“…In the systematic review and meta‐analysis of 68 Ga‐PSMA PET/CT by Perera et al. , of the 4790 men analysed, only 741 were for primary staging (personal communication), with the largest prospective study on primary staging consisting of only 130 men Furthermore, the relationship between a positive 68 Ga‐PSMA PET/CT scan and PSA levels in primary staging was not robust in view of the small numbers in the four studies that assessed this relationship. Therefore, the present study positively adds to the scant information available on the relationship between the traditional risk stratification of prostate cancer (biopsy ISUP grade, screening mpMRI, and screening PSA level) at diagnosis, and the likelihood of identifying a metastasis on primary staging.…”

“…The meta‐analysis by Perera et al. reported the summary sensitivity on a per‐lesion analysis at 75% and specificity of 99%. On a per‐patient analysis the sensitivity and specificity were 77% and 99%, respectively.…”

Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

“…In the salvage phase, the detection rate of 68 Ga‐PSMA PET is strongly correlated to the PSA value at the time of the PET . The high efficacy of blind salvage radiotherapy on the prostatic fossa at PSA values < 0.5 ng/mL demonstrates that most patients with BCR after RP at this PSA level actually experience a local recurrence .…”

Declining use of radical prostatectomy and pelvic lymphadenectomy despite more robotics: National population data over 15 years

“…Experience with newer imaging, such as 68 Ga‐labeled prostate‐specific membrane antigen (PSMA) positron emission tomography (PET), may influence whether PLND is performed, as some practitioners only perform PLND in the presence of PSMA‐avid lymph node, thought to occur in approximately 25% of scans . Other contributors to trends of practice may include limited sensitivity of preoperative nomograms (reported locally to be 38.2% in the primary setting), availability and engagement of primary or post‐operative radiotherapy considering geographic limitations in Australia and limited access to minimally invasive surgery (e.g., RALP platforms).…”

“…Life expectancy has continued to increase in Australia with a greater benefit observed in higher socioeconomic groups, 22 Experience with newer imaging, such as 68 Ga-labeled prostatespecific membrane antigen (PSMA) positron emission tomography (PET), 24,25 may influence whether PLND is performed, as some practitioners only perform PLND in the presence of PSMA-avid lymph node, thought to occur in approximately 25% of scans. 26 Other contributors to trends of practice may include limited sensitivity of preoperative nomograms (reported locally to be 38.2% in the primary setting 27 ), availability and engagement of primary or post-operative radiotherapy considering geographic limitations in Australia and limited access to minimally invasive surgery (e.g., RALP platforms). The therapeutic value of PLND is supported by retrospective reports suggest that PLND may be curative in select cases of low volume nodal disease or with higher lymph node yield at RP.…”