{
  "abstract": "Purpose\n\nTo compare the patient-level diagnostic accuracy of PSMA-PET with multiparametric magnetic resonance imaging (mpMRI), computed tomography (CT), and bone scintigraphy (BS) for initial T, N, and M staging of newly diagnosed intermediate- to high-risk prostate cancer using paired studies.Methods\n\nWe searched PubMed, Embase, Web of Science, and Scopus from inception to December 1, 2025, for paired studies in which the same patients underwent PSMA-PET and conventional imaging, with histopathology or predefined composite criteria as the reference standard. Risk of bias was assessed with QUADAS-2 and QUADAS-C. Pooled sensitivity and specificity with 95% confidence intervals (CIs) were estimated using bivariate composite-likelihood models. Modality effects were tested by meta-regression and likelihood ratio tests, and absolute between-modality differences with 95% CIs were estimated using the delta method.Results\n\nForty-three studies including 4,023 patients were analyzed. For local T staging, PSMA-PET did not show uniform superiority over mpMRI. For extraprostatic extension, PSMA-PET/CT did not differ significantly from mpMRI in sensitivity (absolute difference, -7.6 percentage points; 95% CI, -16.1 to 0.9; p = 0.08) or specificity (-7.0 percentage points; 95% CI, -14.7 to 0.8; p = 0.08); no significant differences were observed for seminal vesicle invasion. In an exploratory six-study comparison, PSMA-PET/MRI had higher sensitivity than mpMRI for extraprostatic extension (+ 12.1 percentage points; 95% CI, 1.9 to 22.2; p = 0.02). For regional lymph node staging, PSMA-PET/CT sensitivity was 69.3% (95% CI, 56.6-79.7) versus 45.3% (95% CI, 33.0-58.3) for mpMRI (difference, + 24.1 percentage points; 95% CI, 6.0-40.3; p = 0.009), whereas specificity did not differ (difference, + 3.2 percentage points; 95% CI, -4.6 to 11.8; p = 0.41). For bone metastasis staging, PSMA-PET had greater sensitivity than BS (95.8% [95% CI, 92.8-98.7] versus 76.2% [95% CI, 68.7-83.8]) and greater specificity (92.8% [95% CI, 89.9-95.7] versus 77.4% [95% CI, 71.3-83.5]; both p < 0.001).Conclusions\n\nPSMA-PET/CT was more sensitive than mpMRI for regional lymph node staging, while specificity was comparable. PSMA-PET had greater sensitivity and specificity than bone scintigraphy for bone metastasis staging. For local T staging, PSMA-PET did not show uniform superiority over mpMRI.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology, West China Hospital, Sichuan University, Chengdu, China.",
    "Department of Urology, West China Hospital, Sichuan University, Chengdu, China. dongqiang@scu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Haowen Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Luchen Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xin Yan"
    },
    {
      "affs": [
        0
      ],
      "name": "Pan Song"
    },
    {
      "affs": [
        1
      ],
      "name": "Qiang Dong"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ear6r3wnpjwas.bib",
  "cited_by": 0,
  "doi": "10.1186/s12885-026-16639-2",
  "fulltext_url": "https://europepmc.org/articles/PMC13700248",
  "id": "ear6r3wnpjwas",
  "issns": [
    "1471-2407"
  ],
  "landing_url": "https://europepmc.org/article/MED/42928137",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7171500834",
  "pdf_url": "https://europepmc.org/articles/PMC13700248?pdf=render",
  "pmcid": "PMC13700248",
  "pmid": "42928137",
  "published": "2026-07-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/ear6r3wnpjwas.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:20Z",
      "native_id": "MED:42928137",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928137"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Prostate Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Comparative diagnostic accuracy of PSMA-PET versus conventional imaging for Initial T/N/M staging of intermediate- to high-risk prostate cancer: a patient-level paired bivariate meta-analysis.",
  "title_text": "Comparative diagnostic accuracy of PSMA-PET versus conventional imaging for Initial T/N/M staging of intermediate- to high-risk prostate cancer: a patient-level paired bivariate meta-analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:20Z",
  "url": "https://research.draconitic.com/paper/ear6r3wnpjwas",
  "venue": "BMC cancer",
  "versions": []
}