Display Settings:

Format

Send to:

Choose Destination
Clin Nucl Med. 2014 Jan;39(1):26-31. doi: 10.1097/RLU.0000000000000291.

Prospective multicenter study of bone scintigraphy in consecutive patients with newly diagnosed prostate cancer.

Author information

  • 1From the *Department of Clinical Physiology, Viborg Hospital, Viborg; †Department of Nuclear Medicine, Aalborg University Hospital, Aalborg; ‡Department of Urology, Viborg Hospital, Viborg; Departments of §Nuclear Medicine and ∥Urology, Regional Hospital West Jutland, Herning; Departments of ¶Clinical Physiology and Nuclear Medicine and #Urology, Randers Hospital, Randers; and **Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Abstract

BACKGROUND:

International guidelines uniformly suggest no routine staging of bone metastasis in patients with bone scintigraphy (BS) in low-risk prostate cancer (PCa). These recommendations are based on retrospective investigations only. In addition, BS has most often been reported as a definitive investigation with no room for equivocal cases.

OBJECTIVE:

The objective of this study was to determine the diagnostic value of BS in a large cohort of consecutive patients with newly diagnosed PCa.

DESIGN, SETTING, AND PARTICIPANTS:

Over a period of 1.5 years in 2008 to 2009, consecutive patients with newly diagnosed PCa were enrolled in a noninterventional, multicenter, observational study. All patients had a whole-body, planar BS. Clinical history and clinical, pathological, and biochemical data were obtained from electronic patient files and questionnaires.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:

Bone scintigraphy was classified into 4 categories as nonmalignant, equivocal, likely malignant, or multiple metastasis. The primary end point was final imaging, which was a composite end point of BS and additional CT and MRI investigations.

RESULTS AND LIMITATIONS:

A total of 635 eligible patients were recruited. Their median prostate-specific antigen (PSA) was 15 ng/mL, median Gleason was 7, and 80% of patients had local disease (T1 or T2). The proportion of nonmalignant BS was 61%, equivocal scans 26%, and likely or definitive metastasis 13%. A total of 154 patients had additional CT or MRI investigations. The final imaging diagnosis showed a prevalence of bone metastases in 87 (13.7%) of 635 patients. No bone metastases were observed in (1) patients with PSA of less than 10 ng/mL, independently of the clinical Tstage and Gleason score (n = 212) and (2) PSA of less than 20 ng/mL if Tstage is less than T3 and Gleason score is less than 8 (n = 97). Approximately 50% of the patients enrolled in this study met these criteria.

CONCLUSION:

This is the first prospective trial to demonstrate that BS can be avoided in patients with low-risk PCa.

PMID:
24217537
[PubMed - in process]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk