Table 2.
Selected studies main characteristics and key point by cancer type.
| Reference | Radiotracer(s) | n pts | Key Point | |
|---|---|---|---|---|
| Prostate | Fanti et al. [8] | [68Ga]Ga-PSMA | 104 | EANM criteria showed a moderate interobserver agreement among multiple readers. |
| Werner et al. [22] | [18F]DCFPyL | 50 | PSMA-RADS showed excellent interobserver agreement for lymph nodes and for the overall scan impression (ICC 0.79 and 0.84, respectively). | |
| Chiu et al. [23] | [68Ga]Ga-PSMA-11 | 56 | PSMA-RADS ratings showed perfect interrater reliability to detect prostate bone metastasis. A SUVmax ratio (lesion-to-blood pool) > 2.2 presented a superior lesion detection rate and specificity when compared to PSMA-RADS. | |
| Letang et al. [24] | [68Ga]Ga-PSMA-11 | 53 | PSMA-RADS had a significantly higher AUROC than the initial reading for the assessment of bone metastasis. | |
| Yin et al. [25] | [18F]DCFPyL | 36 | PSMA-RADS-3A lesions are more likely than PSMA-RADS-3B lesions to represent sites of PCa. | |
| Kuten et al. [26] | [68Ga]Ga-PSMA-11[18F]PSMA-1007 | 15 | In intermediate and high-risk patients staged prior to radical prostatectomy, most PSMA-RADS-3B lesions are of no clinical relevance. | |
| Bhoil et al. [27] | [18F]PSMA-1007 | 203 | A structured reporting with PSMA-RADS grading helps in the proper classification of lesions and standardization of reports. | |
| Garg et al. [28] | [18F]DCFPyL | 28 | A PSA level ≥ 0.6–1.0 ng/mL can be used as a marker for a high index of suspicion for true positivity in PSMA-RADS-3A lesions. A Gleason score ≥ 7 showed a higher rate of PSMA-RADS-3A lesion positivity. | |
| Khatri et al. [29] | [18F]DCFPyL | 30 | The PSF reconstructions allowed the re-categorization of a small number of indeterminate PSMA-RADS-3A soft tissue lesions as more definitive PSMA-RADS-4 lesions. | |
| Mihatsch et al. [30] | [18F]PSMA-1007 | 18 | SUVmax was significantly higher in PSMA-RADS-5 lesions compared to all other categories. PSMA-RADS-3A lesions showed significantly lower SUVmax and SUVpeak compared to the entire PSMA-RADS-4 or -5 cohort. | |
| Gültekin et al. [31] | [68Ga]Ga-PSMA-I&T | 80 | The miN and miM categories showed almost perfect interobserver agreement (K = 0.93 and 0.94, respectively) as well as miM (K = 0.84). | |
| Wang et al. [32] | [68Ga]Ga-PSMA-11 | 187 | Preoperative miTNM correlated with postoperative Gleason score, surgical margin status and time to biochemical recurrence. | |
| Hoberück et al. [33] | [68Ga]Ga-PSMA-11; [18F]PSMA-1007 | 46 | In terms of miTNM staging, both [68Ga]Ga-PSMA-11 and [18F]PSMA-1007 appeared exchangeable, as no tracer outperformed the other. | |
| Koehler et al. [34] | [68Ga]Ga-PSMA-I&T | 297 | Additional late scans of the pelvis in [68Ga]Ga-PSMA-I&T PET/CT detected more lesions and an increasing contrast compared to early imaging, influencing the final miTNM-staging. | |
| Demirci et al. [35] | [68Ga]Ga-PSMA-11 | 133 | The miTNM provides a high level of concordance among readers, with the highest agreement level in miM and lowest agreement in miT. PSMA-RADS showed almost-perfect agreement between readers in terms of scoring (ICC analysis). However, if the results were grouped as benign (score of 1/2), indeterminate (3), and malignant (4/5), Fleiss’ κ analysis showed a moderate level of agreement. | |
| Toriihara et al. [36] | [68Ga]Ga-PSMA-11 | 104 | Comparing the 3 proposed interpretation criteria for PCa, intrareader agreement was moderate to almost perfect. The intercriteria agreement for each site was moderate to almost perfect. | |
| Adnan et al. [12] | [68Ga]Ga-PSMA-11 + [18F]FDG | 47 | The Pro-PET score significantly correlated with symptomatic, biochemical, metabolic, and anatomical responses, as well as with PFS (p = 0.03) and OS (p = 0.027). | |
| Emmett et al. [13] | [68Ga]Ga-PSMA-11 | 291 | The estimated AUC of the PRIMARY score was 0.85 (95%CI: 0.81–0.89) and exceeded that of PI-RADS 0.76 (95%CI: 0.71–0.81) (p = 0.003). Sensitivity, specificity, PPV and NPV for PRIMARY score 3 to 5 (high risk patterns) vs. PRIMARY score 1,2 (low risk patterns) was 88%, 64%, 76% and 81%, compared to 83%, 53%, 69% and 72% for PI-RADS 3–5 vs. 2. | |
| Michalski et al. [37] | [68Ga]Ga-PSMA-11; [18F]PSMA-1007 | 46 | Modified PPP criteria showed high reproducibility. A significant correlation was shown between progressive and non-progressive disease defined by PPP and OS. | |
| Gafita et al. [15] | PSMA-ligand | 124 | Patients with RECIP-PD had shorter OS compared to patients with RECIP-SD/PR | |
| Gafita et al. [38] | PSMA-ligand | 124 | PD patients according to RECIP 1.0 had a higher risk of death compared to non-PD, also in comparison with other response criteria (PPP, RECIST 1.1, aPERCIST) | |
| Neurendocrine | Hope et al. [39] | [68Ga]Ga-DOTA-TATE | 150 | The detection rate of SSTR-positive disease (KS 2–4) resulted of 23%, 38%, and 72% with [111In]Pentetreotide planar scintigraphy, SPECT and PET, respectively. Lesion size did not affect SSTR PET-based KS. |
| Purandare et al. [40] | [68Ga]Ga-DOTA-NOC | 119 | [68Ga]Ga-DOTA-NOC showed a high sensitivity for tumor detection (92.4%) and can help differentiate between typical and atypical carcinoid variants. | |
| Menon et al. [41] | [68Ga]Ga-DOTA-TATE | 32 | No significant change in KS was seen between the delayed scan compared to the standard one (1–1.5 h). | |
| Werner et al. [42] | [68Ga]Ga-DOTA-TOC | 51 | The interobserver agreement for overall scan impression based on SSTR-RADS was excellent (ICC, 0.88), as well as for lymph node and liver lesions (ICC, 0.91 and 0.77, respectively). | |
| Chan et al. [18] | [68Ga]Ga-DOTATATE + [18F]FDG | 62 | NETPET grade showed statistically significant correlation with OS at univariate analysis. NETPET grade was significantly associated with histological grade. | |
| Chan et al. [43] | [68Ga]Ga-DOTATATE + [18F]FDG | 319 | NETPET score significantly correlated with OS and TTP. NETPET showed both high inter-rater (kappa = 0.8) and intra-rater (kappa = 0.9) reliability. | |
| Hayes et al. [44] | [68Ga]Ga-DOTATATE + [18F]FDG | 87 | The dual-tracer PET classification was an independent predictor of OS (multivariate p = 0.016) and predicted PFS (univariate p = 0.030). | |
| Karfis et al. [45] | [68Ga]Ga-DOTATATE + [18F]FDG | 85 | Combined [68Ga]Ga-DOTATATE and [18F]FDG PET imaging classification reached high prognostic value in terms of PFS in GEPNET patients. | |
| Chan et al. [46] | [68Ga]Ga-DOTATATE + [18F]FDG | 38 | The NETPET score and histology were significantly correlated with OS (p = 0.003, p = 0.01) | |
| Zwirtz et al. [19] | [68Ga]Ga-DOTA-TATE/TOC | 34 | Only patients showing progressive disease after two PRRT cycles according to MORE criteria had a worse prognosis, while baseline ZP and ZPnormalized performed best in predicting lesion progression after three cycles of PRRT. | |
| Bone | Kairemo et al. [20] | [18F]NaF | 18 | NAFCIST correlates with changes in bone alkaline phosphatase levels, cumulative dose of [223Ra]Cl2 and OS. |
| Kairemo et al. [47] | [18F]NaF | 18 | Due to mixed response, neither PERCIST nor RECIST were able to predict response in osteosarcoma patients treated with [223Ra]Cl2. Radiomics can help in the assessment of intra-tumoral and inter-tumoral heterogeneity in the response to bone-forming osteosarcoma to [223Ra]Cl2 therapy. | |
| Brain | García Vicente et al. [48] | [18F]Fluorocholine | 47 | Significant differences were found for PFS and OS between incomplete versus complete metabolic resections assessed by the FuMeGa score |
Abbreviations: AUROC, area under the receiver operating characteristic curve; DCFPyL, 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid; GEP, gastroenteropancreatic; ICC, intraclass correlation coefficient; KS, Krenning score; mi, molecular imaging; NAFCIST, [18F]NaF PET response Criteria in Solid Tumors; NET, neuroendocrine tumor; NPV, negative predictive value; OS, overall survival; PCa, prostate cancer; PI, prostate imaging; PD, progressive disease; aPERCIST, adapted PET response criteria in solid tumors; PET/CT, positron emission tomography/computed tomography; PFS, progression free survival; PPP, PSMA PET progression; PPV, positive predictive value; PR, partial response; PRRT, peptide-receptor radionuclide therapy; PSA, prostate-specific antigen; PSF, point-spread function; PSMA, prostate-specific membrane antigen; RADS, Reporting and Data Systems; RECIST, Response Evaluation Criteria in Solid Tumors; SD, stable disease; SPECT, single photon emission tomography; SSTR, somatostatin receptor; SUV, standardized uptake value; TTP, time-to-progression.