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Ann Nucl Med. 2012 Aug;26(7):586-93. doi: 10.1007/s12149-012-0617-0. Epub 2012 Jun 29.

Assessment of bone scans in advanced prostate carcinoma using fully automated and semi-automated bone scan index methods.

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1
Department of Radiology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.

Abstract

OBJECTIVE:

As metastasis of prostate carcinoma occurs in approximately 80 % of terminal prostate carcinoma patients, the prognostic value of the prediction of prostate carcinoma by bone scintigraphy is important. We compared the automated and semi-automated bone scan index (BSI) system with extent of disease (EOD) grade if there is a possibility to substitute for EOD grading.

MATERIALS AND METHODS:

We evaluated the bone scintigraphic images of 158 prostate carcinoma patients (mean age, 69.2 years old; range 50-97). Bone scans were obtained approximately 3 h after the intravenous injection of 740 MBq technetium-99 m-methylene diphosphonate. EOD grade was evaluated by 2 experienced radiologists using bone scintigraphy, magnetic resonance imaging, and computed tomography. We calculated the BSI using the Bonenavi(®) system (Fujifilm RI Pharma Co., Ltd.), utilizing data from a Japanese database. The semi-automated BSI of the patients was obtained by modifying the automated BSI independently by 3 radiologists (referred to as "observers" in this study) with 25, 10, and 4 years of experience. We then compared the EOD with the corresponding 4 independent BSIs for each patient. We used the Steel-Dwass test for multiple comparisons of the BSI among different EOD groups of patients. We analyzed the receiver-operating characteristics (ROC) curve to determine the cutoff values of sensitivity and specificity, which were both set at 95 %.

RESULTS:

There were significant correlations observed among the mean EOD and BSI scores as determined using the Bonenavi(®) system for every patient group for all observers and the automated method. There was also a statistically significant difference in the mean BSI among all EOD groups (grades 0, 1, or 2-4) for all observers and the automated method. Each ROC curve showed an ideal shape and was within the optimal cutoff range.

CONCLUSION:

On the basis of the present results, BSI as calculated using the Bonenavi(®) system significantly correlated with EOD. Sensitivity and specificity as measured by the fully automated method were lower than those of semi-automated BSI with modification by radiologists. Therefore, semi-automated BSI is considered to have the possibility to substitute for EOD grading to predict the survival of prostate carcinoma patients with bone metastases, with only slight interobserver variation.

PMID:
22744807
DOI:
10.1007/s12149-012-0617-0
[Indexed for MEDLINE]
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