This study aimed to perform a head-to-head comparison of the diagnostic efficacy between fluorine-18 prostate-specific membrane antigen-1007 (18F-PSMA-1007) and fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in detecting recurrent and metastatic lesions in patients with prostate cancer (PCa). This retrospective study included 87 patients with recurrent and metastatic who underwent both 18F-FDG and 18F-PSMA-1007 PET/CT within 14 days. The site-specific detection rates and patient-based diagnostic efficacy were compared. The semiquantitative parameters (SUVmax and lesion-to-background ratios) were analyzed. Correlations between serum prostate-specific antigen (PSA) levels and SUVmax, SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were assessed. The influence of PSA levels on diagnostic performance was also evaluated. The overall detection rate of 18F-PSMA-1007 PET/CT was significantly higher than that of 18F-FDG PET/CT [83.9% vs. 51.7%, P 2.0 ng/mL (84.21% vs. 68.42%, P = 0.105). MTV and TLG measured using 18F-PSMA-1007 PET/CT showed moderate correlation with PSA levels (r = 0.431, P = 0.005 and r = 0.469, P = 0.002, respectively). 18F-PSMA-1007 PET/CT outperformed 18F-FDG PET/CT in diagnostic efficacy for detecting recurrent and metastatic PCa, with the greatest advantage observed in patients with low PSA levels (≤ 2.0 ng/mL).
Wang et al. (Wed,) studied this question.