Jing-Ren Tseng

Purpose: Prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) tracers have reshaped prostate cancer (PC) imaging, supplementing non-PSMA options such as choline-based agents. However, direct comparative performance data across tracers remain scarce, leaving the optimal choice uncertain. We therefore conducted a systematic review and network meta-analysis (NMA) to assess detection rates (DRs) among PET tracers used for primary and biochemically recurrent PC. Methods: Following PRISMA-NMA guidelines, we systematically searched PubMed, Embase, Cochrane Library, and ClinicalTrials.gov through March 2025 for studies comparing 2 PET tracers for prostate cancer. The primary outcome was DR, defined as the proportion of PET-positive patients or lesions. Two reviewers independently extracted data on study design, patient demographics, and imaging parameters, and evaluated quality with QUADAS-2. We performed frequentist random-effects NMA to calculate relative risks (RRs) with 95% CIs, using ⁶⁸ Ga-PSMA-11 as reference. Results: Nineteen studies (1681 patients) addressed biochemical recurrence, and 6 (271 patients) targeted primary PC, with 2 overlapping. Risk of bias was low for most domains, though some uncertainty remained for reference standards and timing. In biochemically recurrent PC, PSMA-directed tracers achieved higher DRs than non-PSMA probes. Within the PSMA tracers, ⁶⁴ Cu-PSMA-617 achieved the highest estimated DR, followed by ¹⁸ F-DCFPyL, ¹⁸ F-PSMA-1007, and ⁶⁸ Ga-PSMA-11. Both ¹⁸ F-PSMA-1007 and ¹⁸ F-DCFPyL showed higher DRs than ⁶⁸ Ga-PSMA-11 in primary and recurrent PC. Conclusions: PSMA tracers outperform non-PSMA alternatives for detecting biochemical recurrence. Among PSMA tracers, ¹⁸ F-labeled agents consistently surpass ⁶⁸ Ga-PSMA-11 in both biochemically recurrent and primary PC. When available, ¹⁸ F-labeled PSMA tracers should be preferred.

INPLASY202630033 Comparative detection performance of PET and conventional scintigraphy tracers for inflammation and infection in bone and soft tissue: A systematic review and network meta-analysis…

Sarcomas comprise a heterogeneous group of aggressive mesenchymal malignancies with limited therapeutic options and poor prognosis, underscoring the need f

INPLASY2025100084 Comparative Detection Performance of PSMA and Non-PSMA PET Tracers in Recurrent and Primary Prostate Cancer Keywords: prostate cancer, PSMA, PET, positron emission tomography, Net…

Purpose: Prediction of treatment response to androgen deprivation therapy (ADT) prior to treatment initiation remains difficult. This study was undertaken to investigate whether ⁶⁸Ga-PSMA-11 PET/CT features extracted from different radiomic zones within the prostate gland might predict response to ADT in patients with advanced prostate cancer (PCa). Methods: A total of 35 patients with prostate adenocarcinoma underwent two ⁶⁸Ga-PSMA-11 PET/CT scans—termed PET-1 and PET-2—before and after 3 months of ADT, respectively. The prostate was divided into three radiomic zones, with zone-1 being the metabolic tumor zone, zone-2 the proximal peripheral tumor zone, and zone-3 the extended peripheral tumor zone. Patients in the response group were those who showed a reduction ratio > 30% for PET-derived parameters measured at PET-1 and PET-2. The remaining patients were classified as non-responders. Results: Seven features (glcm_idmn, glcm_idn, glcm_imc1, ngtdm_Contrast, glrlm_rln, gldm_dn, and shape_MeshVolume) from zone-1, two features (gldm_sdlgle and shape_MinorAxisLength) from zone-2, and two features (diagnostics_Mask-interpolated_Minimum and shape_Sphericity) from zone-3 successfully distinguished responders from non-responders to ADT. One predictive feature (shape_SurfaceVolumeRatio) was consistently identified in all of the three zones. Conclusions: this study demonstrates the potential usefulness of radiomic features extracted from different prostatic zones in distinguishing responders from non-responders prior to ADT initiation.

Purpose: The purpose of this pilot prospective study is to examine the gallium-68-prostate-specific membrane antigen-11 ([68Ga]Ga-PSMA-11) positron emission tomography/computed tomography (PET/CT) imaging response in patients with advanced or metastatic hormone-naïve prostate cancer (PC) after 3 months of androgen deprivation therapy (ADT). Methods: We prospectively included men with untreated, clinical stage III or IV PC scheduled to receive ADT for at least 6 months. [68Ga]Ga-PSMA-11 PET/CT images were obtained before the start of ADT and 10–14 weeks thereafter. The following indices were examined: maximum standardized uptake value (SUVmax), mean SUV, PSMA total volume, and PSMA total lesion values of the prostate, nodes, bones, and whole-body. The therapeutic response was assessed using the modified PET response criteria in solid tumors 1.0. A subgroup analysis of patients with the International Society of Urological Pathology (ISUP) grade group 5 versus p < 0.001) after 3 months of ADT. Twenty-four (80%) patients showed partial response. Complete response, stable disease, and disease progression were observed in two patients each. Sixteen patients with ISUP grade group 5 showed a less prominent SUVmax reduction (p = 0.006), and none of them reached complete response. Conclusions: Three months of ADT in patients with untreated, advanced PC significantly reduced PSMA PET/CT indices. While most participants partially responded to ADT, patients with ISUP grade group 5 showed a less prominent SUVmax reduction. Collectively, our pilot results indicate that [68Ga]Ga-PSMA-11 PET/CT imaging holds promise to monitor treatment response after the first three months of ADT.

Background: this study was designed to compare the long-term survival outcomes of patients prepared for radioiodine (RAI) therapy using either thyroid hormone withdrawal (THW) or recombinant human thyrotropin (rhTSH) stimulation, by specifically focusing on cases with distant metastases from papillary thyroid cancer (PTC). Methods: A retrospective analysis was performed on 88 patients with distant metastases from PTC. Fifty-one and thirty-seven patients were prepared for RAI treatment by either THW or rhTSH stimulation, respectively. The primary endpoints were progression-free survival (PFS) and disease-specific survival (DSS). Results: The 10-year DSS rates of patients prepared for RAI therapy using either THW or rhTSH stimulation were 62.2% and 73.3%, respectively. Using multivariate analysis, RAI-avid metastases (p = 0.025) and preparation with rhTSH (p = 0.041) were identified as independent prognostic factors for PFS. Notably, PFS in the group of patients with RAI-avid metastases and preparation with rhTSH was significantly better than that in the other groups (p = 0.025). Conclusions: Preparation for RAI therapy using rhTSH stimulation is not inferior to THW preparation in terms of long-term survival outcomes experienced by patients with PTC and distant metastasis. Patients with RAI-avid metastases and preparation with rhTSH had the most favorable PFS.