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

Objective: We performed a systematic review and meta-analysis to evaluate the application value of flu-orine-18-prostate specific membrane antigen (F-18-PSMA-1007) positron emission tomography/computed to-mography (PET/CT) in patients with different serum prostate specific antigen (PSA) levels and primary pros-tate cancer (PCa) or the biochemical recurrence of Pca. Methods: A comprehensive electronic literature se-arch of the PubMed, Embase and Cochrane Library databases was conducted in accordance with the PRISMA statement. We calculated the pooled sensitivity and specificity of F-PSMA-1007 PET/CT in PCa. A summary 18 receiver operator characteristic (SROC) curve and the area under the curve (AUC) were used to assess the accuracy of F-18-PSMA-1007 PET/CT for PCa. Results: The final analysis included 11 studies that described 799 18 patients and 4261 lesions with F-18-PSMA-1007 PET/CT in PCa. The pooled sensitivity and specificity of F-18-PS -18 18 MA-1007 PET/CT in PCa were 0.836 and 0.946, respectively. The per-patient pooled sensitivity and specificity of F-PSMA-1007 PET/CT in PCa were 0.934 and 0.453, and the per-lesion values were 0.816 and 0.979, res -18 pectively. The pooled sensitivity and specificity of F-PSMA-1007 PET/CT in PCa with PSA>2ng/mL were 18 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 F-18-PSMA-1007 PET/CT in PCa with PSA<2ng/mL were 0.832 and 0.277 in 18 a patient-based analysis, respectively. Conclusion: This meta-analysis showed that F-PSMA-1007 PET/CT 18 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 F-18-PSMA-1007 PET/CT also improves. 18