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Revis?o sistem?tica e meta-an?lise de tomografia por emiss?o de p?sitrons (PET) com ant?geno da membrana espec?fica da pr?stata (PSMA) marcado com 68GA, no c?ncer de pr?stataMatushita, Cristina Sebasti?o 27 June 2018 (has links)
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Previous issue date: 2018-06-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The purpose of this study was to assess the diagnostic performance of 68Ga?Prostate-specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) for detection of prostate cancer and recurrent prostate cancer. Methods: A systematic search was performed in PubMed, Cochrane and Embase to identify relevant published studies reporting on the performance of 68Ga?Prostate-specific Membrane Antigen (PSMA) PET in patients with suspected, confirmed, untreated or recurrent Prostate Cancer. A composite standard included changing in PSA values, clinical follow?up and histopathological findings as reference standard. Results: Thirty-five studies including in total 3532 patients who underwent a 68Ga-PSMA PET met our inclusion criteria. We obtained a pooled positive likelihood ratio (LR) of 1.81 (0.75 to 4.36) with 0% heterogeneity. For patients with PSA <0.5ng/mL, the positive LR pooled estimate was 1.17 (0.37-3.73) and the sensitivity was 56% (0.42-0.68). Conclusion: This meta-analysis of available studies demonstrates that 68Ga-PSMA PET appears to provide good sensitivity and specificity. / O objetivo deste estudo foi avaliar o desempenho diagn?stico da tomografia por emiss?o de p?sitrons (PET) com ant?geno de membrana espec?fico da Pr?stata (PSMA) para detec??o de c?ncer de pr?stata e c?ncer de pr?stata recorrente. M?todos: uma pesquisa sistem?tica foi realizada em PubMed, Cochrane e Embase para identificar estudos relevantes publicados que relatam o desempenho do PSMA PET marcado com 68Ga em pacientes com c?ncer de pr?stata suspeito, confirmado, n?o tratado ou recorrente. Um composto padronizado incluiu altera??o nos valores de PSA, acompanhamento cl?nico e achados histopatol?gicos como padr?o de refer?ncia. Resultados: trinta e cinco estudos, que inclu?ram no total 3532 pacientes submetidos a um PET de 68Ga-PSMA, atendiam aos crit?rios de inclus?o. Obtivemos uma raz?o de verossimilhan?a positiva combinada (LR) de 1,81 (0,75 a 4,36) com 0% de heterogeneidade. Para pacientes com PSA <0,5ng/mL, a estimativa de LR combinada positiva foi de 1,17 (0,37-3,73) e a sensibilidade foi de 56% (0,42-0,68). Conclus?o: Esta meta-an?lise de estudos dispon?veis demonstra que o PET de 68Ga-PSMA parece fornecer boa sensibilidade e especificidade.
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