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  • Review Article
  • Clinical Research
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Head-to-head comparison of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in the detection of biochemical recurrence of prostate cancer: summary of head-to-head comparison studies



Our meta-analysis aimed to evaluate the diagnostic performance of 68Ga-PSMA-11 PET/CT vs. 68Ga-PSMA-11 PET/MRI for biochemical recurrence of prostate cancer.


We searched for relevant articles in PubMed and Embase until February 2022. Studies evaluating head-to-head comparison of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in men with prostate cancer biochemical recurrence were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Performance Studies-2 (QUADAS-2) tool.


A total of 5 studies with 219 patients were included in the analysis. The pooled overall detection rates of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in detecting recurrent PCa after definitive treatment were 0.89 (95% CI: 0.65–1.00), 0.92 (95% CI: 0.77–1.00), while the detection rates were 0.20 (95% CI: 0.05–0.41) and 0.29 (95% CI: 0.10–0.53) in local recurrence, 0.51 (95% CI: 0.33–0.69) and 0.52 (95% CI: 0.44–0.61) in lymph node metastasis, 0.18 (95% CI: 0.07–0.33) and 0.20 (95% CI: 0.09–0.35) in bone metastasis. There was no significant difference between the two imaging modalities in the overall detection rate (P = 0.82). In addition, detection rates were also not significantly different in local recurrence, lymph node metastasis, or bone metastasis (P = 0.54, 1.00, 0.82).


68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI seem to have equivalent performance in detecting biochemical recurrence in prostate cancer. However, the results of the meta-analysis were drawn from studies with small samples. Further larger studies in this setting are warranted.

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Fig. 1
Fig. 2: Summary risk of bias and applicability concerns of the included studies.
Fig. 3: Forest plot showing the pooled overall DR of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in BCR.
Fig. 4: Forest plot showing the pooled DR in local recurrence of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in BCR.
Fig. 5: Forest plot showing the pooled DR in lymph node metastasis of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in BCR.
Fig. 6: Forest plot showing the pooled DR in bone metastasis of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in BCR.
Fig. 7: Column chart showing the pooled DR in different locations.

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Data availability

The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding authors.


  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209–49.

    Article  PubMed  Google Scholar 

  2. Tsechelidis I, Vrachimis A. PSMA PET in Imaging Prostate Cancer. Front Oncol. 2022;12:831429.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cary KC, Punnen S, Odisho AY, Litwin MS, Saigal CS, Cooperberg MR. Nationally representative trends and geographic variation in treatment of localized prostate cancer: the Urologic Diseases in America project. Prostate Cancer Prostatic Dis. 2015;18:149–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Han M, Partin AW, Pound CR, Epstein JI, Walsh PC. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am. 2001;28:555–65.

    Article  CAS  PubMed  Google Scholar 

  5. Cookson MS, Aus G, Burnett AL, Canby-Hagino ED, D’Amico AV, Dmochowski RR, et al. Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol. 2007;177:540–5.

    Article  CAS  PubMed  Google Scholar 

  6. Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65:965–74.

    Article  PubMed  Google Scholar 

  7. Perera M, Papa N, Roberts M, Williams M, Udovicich C, Vela I, et al. Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer-Updated Diagnostic Utility, Sensitivity, Specificity, and Distribution of Prostate-specific Membrane Antigen-avid Lesions: A Systematic Review and Meta-analysis. Eur Urol. 2020;77:403–17.

    Article  PubMed  Google Scholar 

  8. Venkatesan AM, Mudairu-Dawodu E, Duran C, Stafford RJ, Yan Y, Wei W, et al. Detecting recurrent prostate Cancer using multiparametric MRI, influence of PSA and Gleason grade. Cancer Imaging. 2021;21:3.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Masi M, Landoni V, Faiella A, Farneti A, Marzi S, Guerrisi M, et al. Comparison of rigid and deformable coregistration between mpMRI and CT images in radiotherapy of prostate bed cancer recurrence. Phys Med. 2021;92:32–9.

    Article  PubMed  Google Scholar 

  10. Alfarone A, Panebianco V, Schillaci O, Salciccia S, Cattarino S, Mariotti G, et al. Comparative analysis of multiparametric magnetic resonance and PET-CT in the management of local recurrence after radical prostatectomy for prostate cancer. Crit Rev Oncol Hematol. 2012;84:109–21.

    Article  PubMed  Google Scholar 

  11. Trabulsi EJ, Rumble RB, Jadvar H, Hope T, Pomper M, Turkbey B, et al. Optimum Imaging Strategies for Advanced Prostate Cancer: ASCO Guideline. J Clin Oncol. 2020;38:1963–96.

    Article  CAS  PubMed  Google Scholar 

  12. Al-Bayati M, Grueneisen J, Lütje S, Sawicki LM, Suntharalingam S, Tschirdewahn S, et al. Integrated 68Gallium Labelled Prostate-Specific Membrane Antigen-11 Positron Emission Tomography/Magnetic Resonance Imaging Enhances Discriminatory Power of Multi-Parametric Prostate Magnetic Resonance Imaging. Urol Int. 2018;100:164–71.

    Article  CAS  PubMed  Google Scholar 

  13. Liu FY, Sheng TW, Tseng JR, Yu KJ, Tsui KH, Pang ST, et al. Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET-CT vs PET-MRI. Br J Radiol. 2021:20210728.

  14. Sun J, Lin Y, Wei X, Ouyang J, Huang Y, Ling Z. Performance of 18F-DCFPyL PET/CT Imaging in Early Detection of Biochemically Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis. Front Oncol. 2021;11:649171.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kesch C, Vinsensia M, Radtke JP, Schlemmer HP, Heller M, Ellert E, et al. Intraindividual Comparison of (18)F-PSMA-1007 PET/CT, Multiparametric MRI, and Radical Prostatectomy Specimens in Patients with Primary Prostate Cancer: A Retrospective, Proof-of-Concept Study. J Nucl Med. 2017;58:1805–10.

    Article  CAS  PubMed  Google Scholar 

  16. FDA Approves First PSMA-Targeted PET Imaging Drug for Men with Prostate Cancer 2020. Available from:

  17. Almansory KO, Fraioli F. Combined PET/MRI in brain glioma imaging. Br J Hosp Med (Lond). 2019;80:380–6.

    Article  PubMed  Google Scholar 

  18. Verburg FA, Pfestroff A. Imaging: PSMA PET-CT in initial prostate cancer staging. Nat Rev Urol. 2016;13:498–9.

    Article  CAS  PubMed  Google Scholar 

  19. Bianchi L, Schiavina R, Borghesi M, Ceci F, Angiolini A, Chessa F, et al. How does (68) Ga-prostate-specific membrane antigen positron emission tomography/computed tomography impact the management of patients with prostate cancer recurrence after surgery? Int J Urol. 2019;26:804–11.

    Article  PubMed  Google Scholar 

  20. Bashir U, Tree A, Mayer E, Levine D, Parker C, Dearnaley D, et al. Impact of Ga-68-PSMA PET/CT on management in prostate cancer patients with very early biochemical recurrence after radical prostatectomy. Eur J Nucl Med Mol Imaging. 2019;46:901–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Barbaud M, Frindel M, Ferrer L, Le Thiec M, Rusu D, Rauscher A, et al. 68Ga-PSMA-11 PET-CT study in prostate cancer patients with biochemical recurrence and non-contributive 18F-Choline PET-CT: Impact on therapeutic decision-making and biomarker changes. Prostate. 2019;79:454–61.

    Article  CAS  PubMed  Google Scholar 

  22. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–36.

    Article  PubMed  Google Scholar 

  24. Lütje S, Cohnen J, Gomez B, Grüneisen J, Sawicki L, Rübben H, et al. Integrated (68)Ga-HBED-CC-PSMA-PET/MRI in patients with suspected recurrent prostate cancer. Nuklearmedizin. 2017;56:73–81.

    Article  PubMed  Google Scholar 

  25. Afshar-Oromieh A, Haberkorn U, Schlemmer HP, Fenchel M, Eder M, Eisenhut M, et al. Comparison of PET/CT and PET/MRI hybrid systems using a 68Ga-labelled PSMA ligand for the diagnosis of recurrent prostate cancer: initial experience. Eur J Nucl Med Mol Imaging. 2014;41:887–97.

    Article  CAS  PubMed  Google Scholar 

  26. Domachevsky L, Bernstine H, Goldberg N, Nidam M, Stern D, Sosna J, et al. Early (68)GA-PSMA PET/MRI acquisition: assessment of lesion detectability and PET metrics in patients with prostate cancer undergoing same-day late PET/CT. Clin Radio. 2017;72:944–50.

    Article  CAS  Google Scholar 

  27. Jentjens S, Mai C, Ahmadi Bidakhvidi N, De Coster L, Mertens N, Koole M, et al. Prospective comparison of simultaneous [(68)Ga]Ga-PSMA-11 PET/MR versus PET/CT in patients with biochemically recurrent prostate cancer. Eur Radio. 2022;32:901–11.

    Article  CAS  Google Scholar 

  28. Freitag MT, Radtke JP, Afshar-Oromieh A, Roethke MC, Hadaschik BA, Gleave M, et al. Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in (68)Ga-PSMA-11-PET of PET/CT and PET/MRI: comparison with mpMRI integrated in simultaneous PET/MRI. Eur J Nucl Med Mol Imaging. 2017;44:776–87.

    Article  CAS  PubMed  Google Scholar 

  29. Freitag MT, Radtke JP, Hadaschik BA, Kopp-Schneider A, Eder M, Kopka K, et al. Comparison of hybrid (68)Ga-PSMA PET/MRI and (68)Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43:70–83.

    Article  CAS  PubMed  Google Scholar 

  30. Uprimny C, Bayerschmidt S, Kroiss AS, Fritz J, Nilica B, Svirydenka H, et al. Early injection of furosemide increases detection rate of local recurrence in prostate cancer patients with biochemical recurrence referred for (68)Ga-PSMA-11 PET/CT. J Nucl Med. 2021;62:1550–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Duan H, Baratto L, Hatami N, Liang T, Mari Aparici C, Davidzon GA, et al. (68)Ga-PSMA11 PET/CT for biochemically recurrent prostate cancer: Influence of dual-time and PMT- vs SiPM-based detectors. Transl Oncol. 2022;15:101293.

  32. Plaza López PJ, Puertas E, Aguiló JJ, Suarez-Piñera M, Domenech B, Mestre-Fusco A, et al. (68)Ga-PSMA-11 PET/CT in patients with occult biochemical recurrence of prostate carcinoma and negative (18)F-Choline PET/CT. Preliminary assessment of its clinical use. Actas Urol Esp (Engl Ed). 2021;45:353–8.

  33. Tseng JR, Yu KJ, Liu FY, Yang LY, Hong JH, Yen TC, et al. Comparison between (68)Ga-PSMA-11 PET/CT and multiparametric magnetic resonance imaging in patients with biochemically recurrent prostate cancer following robot-assisted radical prostatectomy. J Formos Med Assoc. 2021;120:688–96.

    Article  CAS  PubMed  Google Scholar 

  34. Yuminaga Y, Rothe C, Kam J, Beattie K, Arianayagam M, Bui C, et al. (68)Ga-PSMA PET/CT versus CT and bone scan for investigation of PSA failure post radical prostatectomy. Asian J Urol. 2021;8:170–5.

    Article  PubMed  Google Scholar 

  35. Bagade S, Fowler KJ, Schwarz JK, Grigsby PW, Dehdashti F. PET/MRI evaluation of gynecologic malignancies and prostate cancer. Semin Nucl Med. 2015;45:293–303.

    Article  PubMed  Google Scholar 

  36. Guberina N, Hetkamp P, Ruebben H, Fendler W, Grueneisen J, Suntharalingam S, et al. Whole-body integrated [(68)Ga]PSMA-11-PET/MR imaging in patients with recurrent prostate cancer: comparison with whole-body PET/CT as the standard of references. Mol Imaging Biol. 2020;22:788–96.

    Article  CAS  PubMed  Google Scholar 

  37. Eissa A, Elsherbiny A, Coelho RF, Rassweiler J, Davis JW, Porpiglia F, et al. The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature. Minerva Urol Nefrol. 2018;70:462–78.

    Article  PubMed  Google Scholar 

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HH and BL conceived and designed the study, which were proofed by FY, SS and DH collected and analyzed the data. HH and FY wrote the manuscript. All authors contributed to the article and approved the submitted version.

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Correspondence to Bin Liu or Fuwei Yang.

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Huo, H., Shen, S., He, D. et al. Head-to-head comparison of 68Ga-PSMA-11 PET/CT and 68Ga-PSMA-11 PET/MRI in the detection of biochemical recurrence of prostate cancer: summary of head-to-head comparison studies. Prostate Cancer Prostatic Dis 26, 16–24 (2023).

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