When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?
- Author:
Raj P PAL
1
;
Thivyaan THIRUUDAIAN
;
Masood A KHAN
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Aged, 80 and over; Analysis of Variance; Bone Neoplasms; diagnostic imaging; secondary; Bone and Bones; diagnostic imaging; Humans; Male; Middle Aged; Predictive Value of Tests; Prostate-Specific Antigen; analysis; Prostatic Neoplasms; diagnostic imaging; pathology; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate
- From: Asian Journal of Andrology 2008;10(6):890-895
- CountryChina
- Language:English
-
Abstract:
AIMSTo determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer.
METHODSBetween November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value.
RESULTSOnly 1/61 men (1.6%) with a serum PSA 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups.
CONCLUSIONBased on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA =or< 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.
