ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1525890
This article is part of the Research TopicNext-Generation Radiotherapy for Prostate Cancer: Precision, Personalization, and Technological AdvancesView all articles
The predictive value of PSMA PET/CT in determining pathological upgrading of prostate cancer: a pooling up analysis
Provisionally accepted
- 1Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 2Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 3Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Purpose The issue of pathological upgrading following radical prostatectomy poses a significant challenge for urologists, and prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography(PET/CT) has gained increasing prominence as a preoperative assessment tool for patients with prostate cancer in recent years. This study aims to assess the diagnostic accuracy of PSMA PET/CT in predicting pathological upgrading after radical prostatectomy. Methods We conducted a meta-analysis of diagnostic studies using data from the Cochrane CENTRAL, PubMed, Embase, Scopus, and Web of Science databases through March 2024. We strictly adhered to the guidelines outlined in the PRISMA statement for conducting this diagnostic meta-analysis. We computed the pooled diagnostic accuracy and evaluated heterogeneity while exploring potential sources of heterogeneity through subgroup analysis. Results A total of 7 studies involving 507 patients were included in the final analysis. All participants had biopsy-confirmed prostate cancer and underwent radical prostatectomy. Prior to surgery, all patients underwent PSMA PET/CT imaging. The pooled diagnostic accuracy yielded a sensitivity of 0.68 (95% CI, 0.60-0.76) and specificity of 0.74 (95% CI, 0.59-0.85). The area under the summary receiver operating characteristic curve was calculated as 0.74 (95%CI, 0.70-0.78). Although heterogeneity was observed, its source remained unclear. Conclusion The PSMA PET/CT demonstrates a moderate level of accuracy in predicting pathological upgrading following radical prostatectomy, making it a tool with potential clinical application value, particularly in the field of radiotherapy. However, further studies are warranted to enhance its relevance and applicability.
Keywords: prostate cancer, Radical Prostatectomy, Upgrading, PSMA PET/CT, Predictive Value
Received: 10 Nov 2024; Accepted: 18 Aug 2025.
Copyright: © 2025 Liu, Qu and Zhai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ling-Yun Zhai, Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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