Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review

<b>Background/Objectives</b>: To conduct a systematic review to evaluate the detection rates (DR) of the three FDA-approved PSMA-targeted radiopharmaceuticals in patients with recurrent prostate cancer. <b>Methods</b>: Two individuals systematically searched MEDLINE, ScienceD...

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Main Authors: Soroush Rais-Bahrami, Phillip Davis, Albert Chau, Samuel J. Galgano, Brian F. Chapin, David M. Schuster, Catriona M. Turnbull
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/10/1224
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author Soroush Rais-Bahrami
Phillip Davis
Albert Chau
Samuel J. Galgano
Brian F. Chapin
David M. Schuster
Catriona M. Turnbull
author_facet Soroush Rais-Bahrami
Phillip Davis
Albert Chau
Samuel J. Galgano
Brian F. Chapin
David M. Schuster
Catriona M. Turnbull
author_sort Soroush Rais-Bahrami
collection DOAJ
description <b>Background/Objectives</b>: To conduct a systematic review to evaluate the detection rates (DR) of the three FDA-approved PSMA-targeted radiopharmaceuticals in patients with recurrent prostate cancer. <b>Methods</b>: Two individuals systematically searched MEDLINE, ScienceDirect, and Cochrane Libraries (February 2025), and independently reviewed all results to identify studies reporting patient-level <sup>68</sup>Ga-PSMA-11, <sup>18</sup>F-DCFPyL, or <sup>18</sup>F-flotufolastat DR in ≥100 evaluable patients with recurrent prostate cancer. Sample-weighted means (SWM) of extracted DR were calculated. <b>Results</b>: Of 5059 published articles, 37 met our inclusion criteria, reporting data from 8843 patients undergoing <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 27), <sup>18</sup>F-DCFPyL (<i>n</i> = 8), or <sup>18</sup>F-flotufolastat (<i>n</i> = 2) studies. Heterogeneity was noted across enrolled populations, particularly in prior treatments. <sup>68</sup>Ga-PSMA-11 studies recruited patients with marginally higher median PSA than <sup>18</sup>F-DCFPyL or <sup>18</sup>F-flotufolastat studies (median PSA ranged from 0.1 to 10.7, 0.2–2.5, and 0.6–1.1, respectively). Reported overall DR ranged from 25 to 91% for <sup>68</sup>Ga-PSMA-11, 49–86% for <sup>18</sup>F-DCFPyL, and 73–83% for <sup>18</sup>F-flotufolastat, with SWM of 71%, 66%, and 79%, respectively. Post-prostatectomy DR were reported in 18 articles, resulting in SWM DR of 58% for <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 12), 55% for <sup>18</sup>F-DCFPyL (<i>n</i> = 4), and 76% for <sup>18</sup>F-flotufolastat (<i>n</i> = 2). Among post-radiotherapy patients, SWM were 87% for <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 4), 90% for <sup>18</sup>F-DCFPyL (<i>n</i> = 2), and 99% for <sup>18</sup>F-flotufolastat (<i>n</i> = 1). SWM DR at PSA < 1 ng/mL were 53%, 42%, and 66% for <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 13), <sup>18</sup>F-DCFPyL (<i>n</i> = 5), and <sup>18</sup>F-flotufolastat (<i>n</i> = 2), respectively. <b>Conclusions</b>: Considerable heterogeneity exists across populations in studies of diagnostic PET radiopharmaceuticals. Despite a paucity of <sup>18</sup>F-DCFPyL and <sup>18</sup>F-flotufolastat studies compared with <sup>68</sup>Ga-PSMA-11, the available data suggest that all three radiopharmaceuticals provide high overall DR in patients with biochemical recurrence of prostate cancer.
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spelling doaj-art-ba9b3f996e0942adad3a1fcfd7112cd32025-08-20T03:47:53ZengMDPI AGDiagnostics2075-44182025-05-011510122410.3390/diagnostics15101224Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic ReviewSoroush Rais-Bahrami0Phillip Davis1Albert Chau2Samuel J. Galgano3Brian F. Chapin4David M. Schuster5Catriona M. Turnbull6Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35294, USABlue Earth Diagnostics Inc., Needham, MA 02494, USABlue Earth Diagnostics Ltd., Oxford OX4 4GA, UKDepartment of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USADepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USADivision of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USABlue Earth Diagnostics Ltd., Oxford OX4 4GA, UK<b>Background/Objectives</b>: To conduct a systematic review to evaluate the detection rates (DR) of the three FDA-approved PSMA-targeted radiopharmaceuticals in patients with recurrent prostate cancer. <b>Methods</b>: Two individuals systematically searched MEDLINE, ScienceDirect, and Cochrane Libraries (February 2025), and independently reviewed all results to identify studies reporting patient-level <sup>68</sup>Ga-PSMA-11, <sup>18</sup>F-DCFPyL, or <sup>18</sup>F-flotufolastat DR in ≥100 evaluable patients with recurrent prostate cancer. Sample-weighted means (SWM) of extracted DR were calculated. <b>Results</b>: Of 5059 published articles, 37 met our inclusion criteria, reporting data from 8843 patients undergoing <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 27), <sup>18</sup>F-DCFPyL (<i>n</i> = 8), or <sup>18</sup>F-flotufolastat (<i>n</i> = 2) studies. Heterogeneity was noted across enrolled populations, particularly in prior treatments. <sup>68</sup>Ga-PSMA-11 studies recruited patients with marginally higher median PSA than <sup>18</sup>F-DCFPyL or <sup>18</sup>F-flotufolastat studies (median PSA ranged from 0.1 to 10.7, 0.2–2.5, and 0.6–1.1, respectively). Reported overall DR ranged from 25 to 91% for <sup>68</sup>Ga-PSMA-11, 49–86% for <sup>18</sup>F-DCFPyL, and 73–83% for <sup>18</sup>F-flotufolastat, with SWM of 71%, 66%, and 79%, respectively. Post-prostatectomy DR were reported in 18 articles, resulting in SWM DR of 58% for <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 12), 55% for <sup>18</sup>F-DCFPyL (<i>n</i> = 4), and 76% for <sup>18</sup>F-flotufolastat (<i>n</i> = 2). Among post-radiotherapy patients, SWM were 87% for <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 4), 90% for <sup>18</sup>F-DCFPyL (<i>n</i> = 2), and 99% for <sup>18</sup>F-flotufolastat (<i>n</i> = 1). SWM DR at PSA < 1 ng/mL were 53%, 42%, and 66% for <sup>68</sup>Ga-PSMA-11 (<i>n</i> = 13), <sup>18</sup>F-DCFPyL (<i>n</i> = 5), and <sup>18</sup>F-flotufolastat (<i>n</i> = 2), respectively. <b>Conclusions</b>: Considerable heterogeneity exists across populations in studies of diagnostic PET radiopharmaceuticals. Despite a paucity of <sup>18</sup>F-DCFPyL and <sup>18</sup>F-flotufolastat studies compared with <sup>68</sup>Ga-PSMA-11, the available data suggest that all three radiopharmaceuticals provide high overall DR in patients with biochemical recurrence of prostate cancer.https://www.mdpi.com/2075-4418/15/10/1224biochemical recurrenceprostate cancer imagingprostate specific membrane antigenpositron emission tomography
spellingShingle Soroush Rais-Bahrami
Phillip Davis
Albert Chau
Samuel J. Galgano
Brian F. Chapin
David M. Schuster
Catriona M. Turnbull
Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review
Diagnostics
biochemical recurrence
prostate cancer imaging
prostate specific membrane antigen
positron emission tomography
title Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review
title_full Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review
title_fullStr Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review
title_full_unstemmed Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review
title_short Detection Rates of PSMA-PET Radiopharmaceuticals in Recurrent Prostate Cancer: A Systematic Review
title_sort detection rates of psma pet radiopharmaceuticals in recurrent prostate cancer a systematic review
topic biochemical recurrence
prostate cancer imaging
prostate specific membrane antigen
positron emission tomography
url https://www.mdpi.com/2075-4418/15/10/1224
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