目前的临床建议认为，在初期分期检测分析中进行特定批准的放射性标记的前列腺特异性膜抗原配体正电子发射断层扫描（PSMA PET）以检测转移性前列腺癌。然而，这类配体在定位前列腺内肿瘤（索引肿瘤）和T分期方面的准确性尚未建立。因此，本研究的目标是通过整合使用组织学确认作为参考标准的研究进行的荟萃分析，来确定PSMA-PET在新诊断前列腺癌的肿瘤分期中的诊断准确性。 本研究通过预定义的搜索词条在PubMed、Embase、Web of Science和Cochrane图书馆数据库中进行系统文献搜索。这些词条包括“PSMA PET”、“初期分期”和“前列腺癌”。随后，两名独立的评审员根据预先确定的纳入标准评估所有研究，提取相关数据，并评估证据质量。任何分歧均由第三名评审员解决。采用随机效应Sidik-Jonkman模型进行荟萃分析，并在每位患者基础上估计诊断准确性和95%的置信区间。此外，通过Egger检验和漏斗图的图形检查，对发表偏倚的可能性和小样本效应的影响进行评估。 本分析涵盖了23篇科学论文，共涉及969名患者，并采用定性和定量方法进行了分析。本研究结果表明，无论使用何种类型的PSMA配体，PSMA PET/CT和PSMA PET/MRI对于检测前列腺内肿瘤的诊断准确性分别为86%（95% CI：76-96%）和97%（95% CI：94-100%）。此外，对于检测外前列腺扩展（EPE）的诊断准确性为73%（95% CI：64-82%）和77%（95% CI：69-85%），而对于检测精囊侵犯（SVI）的诊断准确性分别为87%（95% CI：80-93%）和90%（95% CI：82-99%）。 本研究表明，从显著的数据趋势来看，PSMA PET/MRI在诊断准确性方面超过了目前推荐的多参数磁共振成像（mpMRI），而PSMA-PET/CT与mpMRI在检测前列腺内肿瘤和T分期的诊断准确性方面相当。然而，分析发现了一些潜在的局限性，例如小样本效应和发表偏倚的可能性，这可能会影响该研究得出的整体结论。 © 2023年。作者（们），在Springer-Verlag GmbH Germany的专属许可下，属于Springer Nature的一部分。

The current clinical recommendations posit the deployment of specific approved radiolabeled prostate-specific membrane antigen-ligand positron emission tomography (PSMA PET) for detecting metastatic prostate cancer during primary staging. Nevertheless, the precise efficacy of such ligands in localizing intraprostatic tumours (index tumour) and T-staging is not well established. Consequently, the objective of this inquiry is to ascertain the diagnostic accuracy of PSMA-PET in the tumour staging of newly diagnosed prostate cancer by means of a meta-analysis that integrates studies utilizing histological confirmation as the reference standard.In this study, we conducted a systematic literature search of the PubMed, Embase, Web of Science, and Cochrane Library databases using a predefined collection of search terms. These terms included 'PSMA PET', 'primary staging', and 'prostate cancer'. Subsequently, two independent reviewers evaluated all the studies based on predetermined inclusion criteria, extracted pertinent data, and assessed the quality of evidence. Any disparities were resolved by a third reviewer. A random effects Sidik-Jonkman model was applied to conduct a meta-analysis and estimate the diagnostic accuracy on a per-patient basis, along with 95% confidence intervals. Moreover, an appraisal regarding the likelihood of publication bias and the impact of small-study effects was performed utilizing both Egger's test and a graphical examination of the funnel plot.The present analysis comprised a total of twenty-three scientific papers encompassing 969 patients and involved their analysis by both qualitative and quantitative approaches. The results of this study demonstrated that the estimated diagnostic accuracy of PSMA PET/CT and PSMA PET/MRI, for the detection of intraprostatic tumours, regardless of the type of PSMA-ligand, was 86% (95% CI: 76-96%) and 97% (95% CI: 94-100%), respectively. Furthermore, the diagnostic accuracy for the detection of extraprostatic extension (EPE) was 73% (95% CI: 64-82%) and 77% (95% CI: 69-85%), while the diagnostic accuracy for the detection of seminal vesicle involvement (SVI) was 87% (95% CI: 80-93) and 90% (95% CI: 82-99%), respectively.The present investigation has demonstrated that PSMA PET/MRI surpasses currently recommended multiparametric magnetic resonance imaging (mpMRI) in terms of diagnostic accuracy as inferred from a notable data trajectory, whereas PSMA-PET/CT exhibited comparable diagnostic accuracy for intraprostatic tumour detection and T-staging compared to mpMRI. Nevertheless, the analysis has identified certain potential limitations, such as small-study effects and a potential for publication bias, which may impact the overall conclusions drawn from this study.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.