1.When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?
Raj P PAL ; Thivyaan THIRUUDAIAN ; Masood A KHAN
Asian Journal of Andrology 2008;10(6):890-895
<p>AIMSTo determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer.p><p>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.p><p>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.p><p>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.p>
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